Perioperative management of renin-angiotensin system inhibitors in patients undergoing elective major noncardiac surgery: a mixed model investigation using systematic review, meta-analysis, multicentre service evaluation, and national survey.

ABSTRACT:

Background

The risks and benefits of stopping or continuing renin-angiotensin system (RAS) inhibitors for major noncardiac surgery remain uncertain. We conducted an updated systematic review, national service evaluation, and clinician survey to inform the design of a large clinical trial of perioperative RAS inhibitor use.

Methods

We searched MEDLINE, CINAHL, ProQuest, Cochrane database, Scopus, and Web of Science from January 2000 to October 2024 for randomised controlled trials (RCT) of perioperative RAS inhibitor use. The primary outcome was a composite of mortality and major cardiovascular events (MACE). Secondary outcomes included acute perioperative hypertension and hypotension. Meta-analysis was performed using random effects models. The I² index was used t

SUBMITTER: Giannas E 

PROVIDER: S-EPMC12674026 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature