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ANG-First Trial (Angiotensin II as First-Line Vasopressor Therapy in Cardiac Surgery)

ANG-First Trial (Angiotensin II as First-Line Vasopressor Therapy in Cardiac Surgery)

Recruiting
18 years and older
All
Phase 4

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Overview

The purpose of this research is to evaluate the use of Angiotensin II in patients with low blood pressure post-surgery. Your information will be collected for 28 days post the procedure and initiation of the study drug to assess for safety events and complications.

Eligibility

Inclusion Criteria:

  • Adult patients ≥ 18 years of age undergoing cardiac surgery requiring CPB
  • Patients must have clinical features of vasodilation as determined by a MAP \< 65 mmHg that is non-transient in the opinion of the treating physician
  • Patients must be adequately volume resuscitated in the opinion of the treating physician
  • Systemic Vascular Resistance index (SVRi) \< 1970 dynes·sec/cm⁵/m² to support the clinical diagnosis of vasodilation; if no pulmonary artery catheter is in place, vasodilatory hypotension diagnosis according to the judgement of the critical care team
  • Biventricular systolic function is at or greater than pre-cardiopulmonary bypass baseline as demonstrated by echocardiographic evaluation, or the patient is concomitantly treated with

Exclusion Criteria:

  • Bleeding as primary etiology of hypotension, as determined by \> 4 units RBC transfusion in 24 hours.
  • Patients on ECMO
  • Patients with active endocarditis
  • Patients already on renal replacement therapy or creatinine of \> 4 mg/dl within 2 weeks of surgery
  • Patients with contraindications to Angiotensin II including women who are pregnant or breastfeeding or have active coronary ischemia, mesenteric ischemia, limb ischemia, or high potassium (\> 5.5 meq/L) while receiving Angiotensin II

Study details
    Vasodilatory Hypotension During or After Cardiac Surgery

NCT06487585

University of Maryland St. Joseph Medical Center

1 February 2026

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