Is angiotensin II safe for patients on mechanical circulatory support?

Patients on mechanical circulatory support (MCS) receiving angiotensin II (ATII) appear to be more susceptible to thrombosis, reveals a study, noting that the outcome is not statistically significant.

“ATII has been shown in the literature to increase the risk of thrombosis,” but data in patients with MCS are scarce due to their exclusion from landmark trials, the authors said.

Seventy-five patients primarily admitted for cardiac surgery were included in the analysis. Of these, 41 (54.7 percent) were treated with ATII.

Patients on ATII showed numerically higher rates of overall thrombosis than control participants, but the outcome did not reach statistical significance (41.5 percent vs 20.6 percent; p=0.05). In addition, the individual thrombotic components of the composite outcome were not statistically significant between the ATII and control groups.

This retrospective study involved adult patients admitted to the cardiothoracic intensive care unit (CTICU) with temporary MCS. Those aged 18 years or above in the CTICU between 1 September 2018 and 30 August 2022 were included in the analysis.

Eligible patients who received ATII were compared with a control group for the outcome of an index thrombotic event. The Fischer’s exact or chi-squared test was used to compare outcomes.

“This retrospective study provides a single-centre, real-world safety perspective on the use of ATII in MCS,” according to the authors.