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<p>Heart failure with reduced ejection fraction (HFrEF) is frequently observed in patients undergoing coronary artery bypass grafting (CABG), and it significantly increases the risk of postoperative death while exerting a crucial influence on the recovery process following the surgical intervention. HFrEF is one of the prevalent risk factors for early readmission in patients who underwent CABG. Angiotensin receptor-neprilysin inhibitor (ARNI) has been recognized as a critical medical therapy in the management of HFrEF; however, its efficacy and safety have yet to be corroborated in the context of CABG. Therefore, this opinion document developed by a group of cardiothoracic and vascular surgeons in India focuses on the utilization of ARNI for patients with HFrEF, including those undergoing or having undergone CABG. These opinions based on clinical experience include perioperative use of ARNI; postoperative initiation of ARNI; strategies for addressing challenges such as hyperkalemia, hypotension, and renal dysfunction; and initiation of other foundational medical therapies in HFrEF management in the context of CABG.</p>

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Perioperative utilization of angiotensin receptor-neprilysin inhibitor in patients with heart failure with reduced ejection fraction undergoing coronary artery bypass grafting—a narrative review

  • 期刊论文

  • 发表日期：

    2025年1月30日

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  • Manoj Durairaj,
  • Kaushal Pandey,
  • Rajneesh Malhotra,
  • Ritwik Raj Bhuyan,
  • Vijyant Devenraj,
  • Arunkumar Ulaganathan,
  • Abhay Singh Walia,
  • Mohd Azam Haseen,
  • Debasish Sahu,
  • Madhav Kumar,
  • Sangram Keshari Behera,
  • Atul Kumar Gupta,
  • Sanjay Kumar,
  • Chandan Ray Mohapatra,
  • Sanjay Jain,
  • Ambrish Khatod,
  • Tushar Kumar,
  • Neeraj Kumar Sharma,
  • Amrutraj Nerlikar,
  • Soumya Ranjan Mahapatra,
  • Lingraj Nath

摘要

Heart failure with reduced ejection fraction (HFrEF) is frequently observed in patients undergoing coronary artery bypass grafting (CABG), and it significantly increases the risk of postoperative death while exerting a crucial influence on the recovery process following the surgical intervention. HFrEF is one of the prevalent risk factors for early readmission in patients who underwent CABG. Angiotensin receptor-neprilysin inhibitor (ARNI) has been recognized as a critical medical therapy in the management of HFrEF; however, its efficacy and safety have yet to be corroborated in the context of CABG. Therefore, this opinion document developed by a group of cardiothoracic and vascular surgeons in India focuses on the utilization of ARNI for patients with HFrEF, including those undergoing or having undergone CABG. These opinions based on clinical experience include perioperative use of ARNI; postoperative initiation of ARNI; strategies for addressing challenges such as hyperkalemia, hypotension, and renal dysfunction; and initiation of other foundational medical therapies in HFrEF management in the context of CABG.