CRT-600.10 Renin-Angiotensin-Aldosterone System Inhibitors Are Associated With Reno-Protective Effects in Aging Patients Undergoing Transcatheter Aortic Valve Replacement

Okoh, Alexis K.; Singh, Swaiman; Al-Obaidi, Nawar; Haik, Bruce; Chen, Chunguang; Cohen, Marc; Waxman, Sergio; Agarwal, Sandeep; Russo, Mark

doi:10.1016/j.jcin.2020.01.156

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…52 Furthermore, an observational study in TAVI patients found that glomerular filtration rate increased from baseline more significantly in RAASi patients (40%) compared with non-RAASi (29%) (p=0.001) and RAASi was independently associated with reduction in risk of development of postoperative AKI (OR 0.51, 95% CI 0.28 to 0.91, p=0.0024). 40 Other outcomes such as hospital readmission (p=0.24), atrial fibrillation (p=0.92), stroke (p=0.31) and need for permanent pacemaker implantation (p=0.94) were also not statistically significant ( table 4 ) with follow-up period ranging from 30 days to 3 years. When meta-analyses were excluded studies of less than 1-year follow-up, 44 52 no statistical differences in outcomes were still observed.…”

Section: Resultsmentioning

confidence: 90%

Antihypertensive therapies in moderate or severe aortic stenosis: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

BackgroundHypertension confers a poor prognosis in moderate or severe aortic stenosis (AS), however, antihypertensive therapy (AHT) is often not prescribed due to the perceived deleterious effects of vasodilation and negative inotropes.ObjectiveTo assess the efficacy and safety outcomes of AHT in adults with moderate or severe AS.DesignSystematic review and meta-analysis.Data sourcesThe Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and grey literature were searched without language restrictions up to 9 September 2019.Study eligibility criteria, appraisal and synthesis methodsTwo independent reviewers performed screening, data extraction and risk of bias assessments from a systematic search of observational studies and randomised controlled trials comparing AHT with a placebo or no AHT in adults with moderate or severe AS for any parameter of efficacy and safety outcomes. Conflicts were resolved by the third reviewer. Meta-analysis with pooled effect sizes using random-effects model, were estimated in R.Main outcome measuresMortality, Left Ventricular (LV) Mass Index, systolic blood pressure, diastolic blood pressure and LV ejection fractionResultsFrom 3025 publications, 31 studies (26 500 patients) were included in the qualitative synthesis and 24 studies in the meta-analysis. AHT was not associated with mortality when all studies were pooled, but heterogeneity was substantial across studies. The effect size of AHT differed according to drug class. Renin–angiotensin–aldosterone system inhibitors (RAASi) were associated with reduced risk of mortality (Pooled HR 0.58, 95% CI 0.43 to 0.80, p=0.006), The differences in changes of haemodynamic or echocardiographic parameters from baseline with and without AHT did not reach statistical significance.ConclusionAHT appears safe, is well tolerated. RAASi were associated with clinical benefit in patients with moderate or severe AS.

show abstract

Section: Resultsmentioning

confidence: 90%