ArticleBritish journal of anaesthesia2024
Should renin-angiotensin system inhibitors be held prior to major surgery?
Article in British journal of anaesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- 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.British journal of anaesthesia · 2025Pooled it
- Impact of continuing renin-angiotensin-aldosterone system inhibitors before surgery on intraoperative hypotensive events: a secondary analysis of the STOP-or-NOT Trial.British journal of anaesthesia · 2026Trial
- Establishing the Median Effective Dose of Tegileridine for Immediate Postoperative Analgesia Following Laparoscopic Colorectal Cancer Surgery: A Sequential Dose-Finding Study.Drug design, development and therapy · 2026Article
- The use of terlipressin to treat refractory hypotension during allograft kidney transplantation: a report of 4 cases and literature review.BMC anesthesiology · 2025Review
- Stopping versus continuing renin-angiotensin system inhibitors before surgery: An updated systematic review and meta-analysis of randomised controlled trials.Indian journal of anaesthesia · 2025Article
- Predictive value of modified frailty index-5 to major complications after videothoracoscopic pulmonary resections.Updates in surgery · 2025Article
- Perioperative antihypertensive medications and effects on functional decline and mortality in non-cardiac surgery.European heart journal open · 2025Article
- Evaluating the risks and benefits of continuingBJA open · 2025Review
- Management of renin-angiotensin system inhibitors prior to major surgery: insights from the STOP-or-NOT trial.British journal of anaesthesia · 2025Article
- Preoperative continuation vs. discontinuation of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers on early cognitive function in elderly patients undergoing noncardiac surgery: a randomized controlled trial.Frontiers in aging neuroscience · 2025Article
- The prognostic significance of modified frailty index-5 in patients undergoing pneumonectomy for lung cancer.Interdisciplinary cardiovascular and thoracic surgery · 2024Article
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1 author at 1 institution in 1 country.
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Abstract
Many patients undergoing surgical procedures have a history of hypertension, diabetes mellitus, heart failure, or a combination. Often, these conditions involve the chronic use of a renin-angiotensin system inhibitor, including angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). Observational studies have suggested that continuing ACEIs/ARBs before major noncardiac surgery can increase the risk of intraoperative hypotension, which might drive postoperative complications such as acute kidney injury, myocardial injury, or stroke. Strong recommendations on how to manage ACEIs/ARBs before surgery are, however, lacking owing to insufficient evidence, mostly limited to data from observational studies. Recently, the SPACE trial investigated the impact of preoperative management of ACEIs/ARBs on postoperative myocardial injury. Myocardial injury occurred in 48.3% patients randomised to discontinue and 41.3% patients randomised to continue ACEI/ARB (odds ratio for continuing: 0.77, 95% confidence interval 0.45-1.31). Patients randomised to the 'Stop' group experienced more postoperative hypertension. In a post hoc analysis, patients randomised to the 'Continue' group with low preoperative NT-proBNP concentrations (<100 pg ml
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.