ArticleFrontiers in aging neuroscience2025
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.
Article in Frontiers in aging neuroscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To evaluate the effect of preoperative continuation vs. discontinuation of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) on early cognitive function in elderly patients undergoing noncardiac surgery. Methods: This prospective randomized controlled study was performed at the Affiliated Hospital of Xuzhou Medical University. Elderly patients aged 65 years or older, scheduled for elective noncardiac surgery under general anesthesia, and receiving long-term ACEI/ARBs therapy were randomly assigned to either continue or discontinue ACEI/ARBs therapy on the morning of surgery. The primary outcome was postoperative early cognitive function, assessed via neuropsychological tests including Auditory Verbal Learning Test-Huashan (AVLT-H), Clock Drawing Test (CDT), Number Connection Test (NCT), and Digit Span Test (DST) preoperatively and on postoperative day 1 (POD1). Secondary outcomes included intraoperative hypotension, use of phenylephrine, intraoperative fluid administration, incidence of hypertension, and length of hospital stay. Results: The NCT scores in the discontinued use of ACEI/ARBs group showed a significant decline on POD1 compared to baseline ( Conclusion: Preoperative continuation or discontinuation of ACEI/ARBs did not significantly affect early postoperative cognitive function in elderly patients.
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