Angiotensin Receptor-Neprilysin Inhibitor Suppresses Renin-Angiotensin-Aldosterone System Activation After Cardiac Surgery Using Cardiopulmonary Bypass

DOI Web Site 参考文献28件
  • Hoshino Joji
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University Department of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center
  • Saito Shunsuke
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Shibasaki Ikuko
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Sairenchi Toshimi
    Medical Science of Nursing, School of Nursing, Dokkyo Medical University
  • Okubo Shohei
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Matsuoka Taiki
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Hirota Shotaro
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Yokoyama Shohei
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Kanazawa Yuta
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Tezuka Masahiro
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Takei Yusuke
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Tsuchiya Go
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Konishi Taisuke
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Ogata Koji
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University
  • Fukuda Hirotsugu
    Department of Cardiac and Vascular Surgery, Dokkyo Medical University

抄録

<p>Background: Sacubitril/valsartan, being both a neprilysin inhibitor and angiotensin receptor blocker, exhibits a renin-angiotensin-aldosterone system (RAAS) inhibitory effect. However, no study has investigated the administration of sacubitril/valsartan in patients early after surgery using cardiopulmonary bypass.</p><p>Methods and Results: This was a prospective observational study of 63 patients who underwent open heart surgery and were treated with sacubitril/valsartan. No serious adverse events occurred. Among the 63 patients, sacubitril/valsartan was discontinued in 13 due to hypotension (n=10), renal dysfunction (n=2), and dizziness (n=1). Atrial natriuretic peptide concentrations increased significantly from Day 3 of treatment (P=0.0142 vs. Postoperative Day 1) and remained high thereafter. In contrast, plasma renin activity was significantly suppressed from Day 3 onwards (P=0.00206 vs. Postoperative Day 1). A decrease in creatinine concentrations and an increase in the estimated glomerular filtration rate were observed on Day 3; this improvement in renal function was not observed in the historical control group, in which patients did not receive sacubitril/valsartan. New postoperative atrial fibrillation was less frequent in the study group compared with the historical control (12.7% vs. 38.0%; P=0.0034).</p><p>Conclusions: Sacubitril/valsartan administration was safe immediately after open heart surgery in patients without postoperative hypotension. It enhanced serum atrial natriuretic peptide concentrations and suppressed RAAS activation.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal advpub (0), 2024-04-24

    一般社団法人 日本循環器学会

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