PHRI Scientist Maura Marcucci presented today at ACC 2022 on the arm of the POISE-3 trial looking at blood pressure management for patients undergoing noncardiac surgery.
“We found no significant difference in the incidence of our primary outcome in the two groups” measuring the impact of hypotension-avoidance strategy versus hypertension-avoidance strategy,” said Marcucci.
Marcucci noted in her presentation that this POISE-3 research informs questions that commonly confront physicians taking care of patients undergoing surgery, including whether or not to withhold certain medications for patients before surgery.
She added that further research is needed to evaluate perioperative interventions that can modify hemodynamics to an extent, and in a direction that will lead to a favourable impact on clinical outcomes.
POISE-3’s blood pressure management arm randomized 7,490 patients – 45 or older (mean age 70; 56% men) – at 110 centers in 22 countries. All were undergoing inpatient noncardiac surgery, were deemed to be at increased risk for perioperative cardiovascular events, and were chronically taking at least one antihypertensive medication.
“POISE-3 does not show that hemodynamics doesn’t matter; it does matter,” Marcucci said at a press briefing at ACC 2022, adding that “we should look to evaluate other perioperative interventions that might affect hemodynamics in a favorable way so that we can see an effect also on clinical outcomes.”
Commenting for TCTMD, ACC President Edward Fry, MD called this a very practical trial, as cardiologists often get calls from anesthesiologists regarding what should be done about a patient’s antihypertensive therapy during elective noncardiac surgery. He notes, “There’s huge variability in terms of how that’s done… very rarely is enough thought given to how to manage those medications in a protocolized way.”
In this TCTMD video, Marcucci chats with Yazan Daaboul about the study:
Marcucci’s ACC 2022 presentation is available as a downloadable PDF.
She was also interviewed on video by TouchCardio.
Some Twitter coverage of Marcucci’s POISE-3 presentation included:
#ACC22 # POISE3
The Effects Of A Hypotension-avoidance Strategy 🆚 Hypertension-avoidance Strategy In Noncardiac Surgery
🫀Withholding BP meds common practice in Sx to avoid hypotension
🫀RCT: Hypo-Avoidance 🆚 HTN-Avoidance
🫀~1/3 on 3 meds for HTN pic.twitter.com/yDsndZfw4f
— Dr. Martha Gulati “Get Vaccinated Please” (@DrMarthaGulati) April 4, 2022