非心脏手术前使用ACE抑制剂和arb ？新出现的证据建议采取针对患者的方法。

IF 4.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Cleveland Clinic Journal of Medicine Pub Date : 2025-10-01 DOI:10.3949/ccjm.92a.25035

Maureen Keshock, Elise Zhang, Christopher Whinney, Kenneth C Cummings

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引用次数: 0

摘要

尽管在非心脏手术前停用这些药物可以降低术中低血压的风险，但最近的试验表明，它会对病情较重的患者造成伤害。个体化治疗是最安全的，尤其是对心力衰竭患者。这篇综述探讨了关于暂停和继续使用这些药物对术中低血压、心肌损伤、急性肾损伤和术后预后影响的新证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Hold ACE inhibitors and ARBs before noncardiac surgery? Emerging evidence suggests a patient-specific approach.

Although withholding these drugs before noncardiac surgery reduces the risk of intraoperative hypotension, recent trials suggest that it leads to harm in sicker patients. An individualized approach is safest, particularly in patients with heart failure. This review examines the emerging evidence regarding the impact of pausing vs continuing these drugs on intraoperative hypotension, myocardial injury, acute kidney injury, and postoperative outcomes.

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来源期刊

Cleveland Clinic Journal of Medicine 医学-医学：内科

CiteScore

3.80

自引率

0.00%

发文量

109

审稿时长

6-12 weeks

期刊介绍： The mission of Cleveland Clinic Journal of Medicine (CCJM) is to provide its readers with up-to-date, practical, clinical information relevant to internal medicine, cardiology, and related fields. Consistent with this mission, CCJM focuses on timely review articles and other content that has a continuing-education orientation rather than on original research or case reports. CCJM authors, drawn from Cleveland Clinic and other top medical institutions throughout the world, are asked to identify new findings that are changing the practice of medicine and to advise readers how to apply them in daily patient care. Authors are chosen for their experience, acquired through caring for patients, teaching other physicians, and researching clinical questions.