Effect of Angiotensin II Antagonism on Gastrointestinal Bleeding in Patients With Left Ventricular Assist Devices: A Systematic Review and Meta-Analysis

ASAIO J. 2022 Dec 1;68(12):1470-1474. doi: 10.1097/MAT.0000000000001688. Epub 2022 Mar 14.

Abstract

The importance of medical therapy to ameliorate the incidence and impact of left ventricular assistance device-related gastrointestinal bleeding has been highlighted recently with several single-center studies. Electronic databases were searched for studies that compared the incidence of gastrointestinal bleeding for those people on left ventricular assist support with and without angiotensin II inhibition. Angiotensin II inhibition was associated with a lower incidence of gastrointestinal bleeding (pooled RR 0.58, 95% confidence interval (CI): 0.34-0.98; p = 0.04], with a trend toward toward lower incidence with arteriovenous malformation-associated gastrointestinal bleeding (pooled RR 0.50, 95% CI: 0.25-1.03; p = 0.06).

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Angiotensin II
  • Arteriovenous Malformations* / complications
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / prevention & control
  • Heart Failure* / complications
  • Heart Failure* / surgery
  • Heart-Assist Devices* / adverse effects
  • Humans
  • Retrospective Studies

Substances

  • Angiotensin II