Overview

Management of Angiotensin Inhibitors During the Perioperative Period

Status:
Recruiting

Trial end date:
2023-09-01

Target enrollment:
0

Participant gender:
All

Summary

This is a multicenter randomized clinical trial to determine the effect of continuation versus withdrawal of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) in the perioperative period on postoperative complications.

Phase:

N/A

Accepts Healthy Volunteers?

Details

Lead Sponsor:

UMC Utrecht

Collaborator:

ZonMw: The Netherlands Organisation for Health Research and Development

Treatments:

Angiotensin-Converting Enzyme Inhibitors
Enzyme Inhibitors

Criteria

Inclusion Criteria:

- Chronic ACEI or ARB use for the treatment of hypertension. Patients who use a
com-bination pill with a diuretic are eligible as well;

- Scheduled for elective intermediate to high risk noncardiac surgery, defined according
to the European Society of Cardiology / European Society of Anesthesiology guidelines
on noncardiac surgery;

- Expected postoperative length of stay of at least two days.

Exclusion Criteria:

- Severe chronic kidney disease, defined as GFR<30 ml/min/1.73 m2;

- ACEI/ARB use for the treatment of chronic systolic heart failure, defined as left
ven-tricular ejection fraction ≤40%;

- ACEI/ARB use within one year after ST-elevated myocardial infarction, according to the
fourth universal definition of myocardial infarction;

- Transplant surgery;

- ACEI/ARB use in a combination pill together with a drug other than a diuretic,
including calcium channel blockers, beta-blockers and neprilysin inhibitors;

- Use of drugs acting on the renin-angiotensin-aldosterone system other than ACEI/ARB,
e.g. aliskiren.