Published online Dec 26, 2023. doi: 10.12998/wjcc.v11.i36.8498
Peer-review started: October 12, 2023
First decision: November 28, 2023
Revised: November 29, 2023
Accepted: December 5, 2023
Article in press: December 5, 2023
Published online: December 26, 2023
Processing time: 71 Days and 7.1 Hours
Sepsis is a syndrome that involves physiological, pathological, and biochemical abnormalities resulting from a host response to an infection, and represents a major public health concern.
Therefore, it is important to accurately identify potential patients who are at a high risk of sepsis and to take specific intervention measures to reduce the mortality of such patients. Several studies have suggested that the use of angio
The effect of ACEI or ARB on the mortality of patients with sepsis is not well characterized.
To elucidate the association between prior ACEI or ARB exposure and mortality in sepsis.
This study followed the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. A literature search of relevant published studies that analyzed the association between the sepsis, mortality, and ACEIs or ABBs was conducted on 27 March 2020. We used the PubMed (http://www.ncbi.nlm.nih.gov/pubmed/), EMBASE (http://www.embase.com/), Web of Science (http://wokinfo.com/), and Cochrane Library (http://www.thecochranelibrary.com/) databases to identify articles using the following terms: “hypotensor”; “antihypertensive”; “ACEIs”; “captopril”; “enalapril”; “sirapley”; “benazepril”; “petitopril”; “ramipril”; “ARBs”; “losartan”; “irbesartan”; “valsartan”; “telmisartan”; “sepsis”; “toxic shock”; “sepsis shock”; and “mortality”. In addition, the reference lists in each of the studies were reviewed to identify additional studies. The language of the studies was limited to English, and we did not search for unpublished literature.
A total of 48 potentially relevant records were reviewed, of which six articles, which included 49799 cases that met the inclusion criteria were included in the meta-analysis. A total of 42 studies were subsequently excluded because they used a combined intervention, were duplicated reports, or were of relatively low quality. All of the six selected articles were cohort studies.
The findings of this systematic review suggests that exposure to ACEIs or ARBs prior to an episode of sepsis could have a role in reducing sepsis mortality.
However, additional evidence is required to clarify whether premorbid ACEIs or ARBs can reduce sepsis mortality, as well as the associated mechanism. Therefore, further high-quality cohort studies and molecular mechanism experiments are required to confirm our results.