{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T01:20:03Z","timestamp":1793582403009,"version":"4.5.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,10,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Postoperative clinical outcomes associated with the preoperative continuation or discontinuation of angiotensin\u2010converting enzyme inhibitors (\n              <jats:styled-content style=\"fixed-case\">ACEIs<\/jats:styled-content>\n              ) or angiotensin receptor blockers (\n              <jats:styled-content style=\"fixed-case\">ARBs<\/jats:styled-content>\n              ) before cardiac surgery remain unclear.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In a single\u2010center, open\u2010label, randomized, registry\u2010based clinical trial, patients undergoing nonemergent cardiac surgery were assigned to\n              <jats:styled-content style=\"fixed-case\">ACEI<\/jats:styled-content>\n              \/\n              <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content>\n              continuation or discontinuation 2\u00a0days before surgery. Among the 584 patients screened, 261 met study criteria and 126 (48.3%) patients were enrolled. In total,121 patients (96% adherence; 60 to continuation and 61 to\n              <jats:styled-content style=\"fixed-case\">ACEI<\/jats:styled-content>\n              \/\n              <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content>\n              discontinuation) underwent surgery and completed the study protocol, and follow\u2010up was 100% complete. Postoperative intravenous vasopressor use (78.3% versus 75.4%,\n              <jats:italic>P<\/jats:italic>\n              =0.703), vasodilator use (71.7% versus 80.3%,\n              <jats:italic>P<\/jats:italic>\n              =0.265), vasoplegic shock (31.7% versus 27.9%,\n              <jats:italic>P<\/jats:italic>\n              =0.648), median duration of vasopressor (10 versus 5\u00a0hours,\n              <jats:italic>P<\/jats:italic>\n              =0.494), and vasodilator requirements (10 versus 9\u00a0hours,\n              <jats:italic>P<\/jats:italic>\n              =0.469) were not significantly different between the continuation and discontinuation arms. No differences were observed in the incidence of acute kidney injury (1.7% versus 1.6%,\n              <jats:italic>P<\/jats:italic>\n              =0.991), stroke (no events, mortality (1.7% versus 1.6%,\n              <jats:italic>P<\/jats:italic>\n              =0.991), median duration of mechanical ventilation (6 versus 6\u00a0hours,\n              <jats:italic>P<\/jats:italic>\n              =0.680), and median intensive care unit length of stay (43 versus 27\u00a0hours,\n              <jats:italic>P<\/jats:italic>\n              =0.420) between the treatment arms.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A randomized study evaluating the routine continuation or discontinuation of\n              <jats:styled-content style=\"fixed-case\">ACEIs<\/jats:styled-content>\n              or\n              <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content>\n              s before cardiac surgery was feasible, and treatment assignment was not associated with differences in postoperative physiological or clinical outcomes. These preliminary findings suggest that preoperative\n              <jats:styled-content style=\"fixed-case\">ACEI<\/jats:styled-content>\n              \/\n              <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content>\n              management strategies did not affect the postoperative course of patients undergoing cardiac surgery.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n              :\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier:\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              02096406.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.009917","type":"journal-article","created":{"date-parts":[[2018,10,12]],"date-time":"2018-10-12T09:05:19Z","timestamp":1539335119000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Comparison of Angiotensin\u2010Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Management Strategies Before Cardiac Surgery: A Pilot Randomized Controlled Registry Trial"],"prefix":"10.1161","volume":"7","author":[{"given":"Sean","family":"van Diepen","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada"},{"name":"Division of Cardiology Department of Medicine University of Alberta Edmonton Alberta Canada"},{"name":"Canadian VIGOUR Center University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen M.","family":"Norris","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada"},{"name":"Division of Cardiac Surgery University of Alberta Hospital Edmonton Alberta Canada"},{"name":"Faculty of Nursing University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinggan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Canadian VIGOUR Center University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayan","family":"Nagendran","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery University of Alberta Hospital Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle M.","family":"Graham","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damaris","family":"Gaete Ortega","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek R.","family":"Townsend","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin A.","family":"Ezekowitz","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine University of Alberta Edmonton Alberta Canada"},{"name":"Canadian VIGOUR Center University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean M.","family":"Bagshaw","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211585"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60141-5"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0804626"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01428-4"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(98)70049-2"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05271107"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.05.021"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0b013e32830a6daf"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.06.018"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03018973"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.07.008"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e3182742c84"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.114.2.487"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.323"},{"key":"e_1_3_2_16_2","first-page":"286","article-title":"Drug therapy before coronary artery surgery: nitrates are independent predictors of mortality and beta\u2010adrenergic blockers predict survival","volume":"88","author":"Weightman WM","year":"1999","unstructured":"Weightman WM, Gibbs NM, Sheminant MR, Whitford EG, Mahon BD, Newman MA. 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