Angiotensin Receptor-Neprilysin Inhibitor Suppresses Renin-Angiotensin-Aldosterone System Activation After Cardiac Surgery Using Cardiopulmonary Bypass
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- Hoshino Joji
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University Department of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center
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- Saito Shunsuke
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Shibasaki Ikuko
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Sairenchi Toshimi
- Medical Science of Nursing, School of Nursing, Dokkyo Medical University
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- Okubo Shohei
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Matsuoka Taiki
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Hirota Shotaro
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Yokoyama Shohei
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Kanazawa Yuta
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Tezuka Masahiro
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Takei Yusuke
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Tsuchiya Go
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Konishi Taisuke
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- Ogata Koji
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University
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- 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
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- Circulation Journal
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Circulation Journal advpub (0), 2024-04-24
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390299915004569600
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- ISSN
- 13474820
- 13469843
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
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- 抄録ライセンスフラグ
- 使用不可