JAHA:心脏手术前要不要停用ACEI/ARB?

2022-06-10 xing.T MedSci原创

由此可见,这项评估心脏手术前常规继续服用或停用ACEI或ARB的随机研究是可行的,并且治疗分配与术后生理或临床结局的差异无关。

在心脏手术前持续或停用血管紧张素转换酶抑制剂(ACEIs)或血管紧张素受体阻滞剂(ARBs)相关的术后临床结局尚不清楚。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,在这项单中心、公开分组、随机、基于登记中心的临床试验中,接受非紧急心脏手术的患者在手术前2天被分配至继续服用或停用ACEI/ARB组别中。在筛选的584名患者中,261名患者符合研究标准,126名(48.3%)患者被招募入组。

总共有121名患者(96%的依从性; 60名继续服用ACEI/ARB治疗和61名患者停用ACEI/ARB)接受了手术治疗并完成了研究方案,随访完成率为100%。继续服用或停用ACEI/ARB两组间术后静脉输注血管加压剂(78.3% vs. 75.4%,P=0.703)、血管扩张剂使用(71.7% vs. 80.3%,P=0.265)、血管麻痹性休克(31.7% vs. 27.9%,P=0.648)、血管加压剂持续时间中位数(10 vs. 5小时,P=0.494)、需要血管扩张剂治疗时间(10 vs. 9小时,P=0.469)没有显著差异。急性肾损伤(1.7% vs. 1.6%,P=0.991)和卒中(无事件死亡率(1.7% vs. 1.6%,P=0.991)的发生率、机械通气持续时间中位数(6 vs. 6,P=0.680)以及重症监护室停留时间长短(43 vs. 27小时,P=0.420)两组之间也没有差异。

由此可见,这项评估心脏手术前常规继续服用或停用ACEI或ARB的随机研究是可行的,并且治疗分配与术后生理或临床结局的差异无关。这些初步研究结果表明术前ACEI/ARB管理策略不影响接受心脏手术的患者的术后病程。

原始出处:

Sean van Diepen.et al. Comparison of Angiotensin‐Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Management Strategies Before Cardiac Surgery: A Pilot Randomized Controlled Registry Trial.JAHA.2018. https://www.ahajournals.org/doi/full/10.1161/JAHA.118.009917

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    2022-09-07 ms2000002029356653

    学习了

    0

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    2019-06-08 shanyongle
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    2018-10-15 白袍甘道夫

    学习了

    0

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    2018-10-15 zhaohui6731

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