• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Renin-angiotensin system inhibition following transcatheter aortic valve replacement linked with lower cardiac mortality

byJames EnglandandAnees Daud
August 5, 2019
in Cardiology, Chronic Disease, Nephrology
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. Use of medications to inhibit the renin-angiotensin system (RAS) following transcatheter aortic valve replacement (TAVR) for severe aortic stenosis linked with reduced cardiac mortality at 3 years.

2. RAS inhibition was also demonstrated to have a greater reduction in ventricular volume and septal hypertrophy on follow-up echocardiogram.

Evidence Rating Level: 2 (Good)

Study Rundown: The use of transcatheter aortic valve replacement (TAVR) for severe aortic stenosis has become more common, with improved clinical outcomes in patients at intermediate- or high-risk for surgery. Aortic stenosis is often associated with adverse cardiac remodeling and fibrosis which may persist despite the correction of the mechanical defect with valve replacement. The adverse remodeling has been linked with poorer outcomes following TAVR, but the impact of medical therapy is not clear. The current study sought to evaluate the impact of renin-angiotensin system (RAS) inhibition on clinical and echocardiographic outcomes following TAVR in patients with aortic stenosis. The retrospective analysis found that use of RAS inhibitors in this population was linked with lower cardiac mortality at 3-years and reduced left ventricular volume and hypertrophy. Use of RAS inhibitors was also associated with reduced rates of atrial fibrillation, cerebrovascular events, and readmissions.

The findings of this study provide support for a randomized clinical trial to confirm the cardioprotective effects of these medications following TAVR. The main strength of the study is the large population of patients undergoing TAVR with serial echocardiographic and clinical follow-up. The main limitations of the study stem from the retrospective design with differences in baseline comorbid conditions between those who were and were not on RAS inhibitors.

Click to read the study in JACC

RELATED REPORTS

Commonly cited medication triggers may not increase risk of microscopic colitis among older adults

Spironolactone ineffective for patients with preserved ejection fraction after myocardial infarction

Mineralocorticoid receptor antagonists reduce hospitalizations in patients with heart failure with preserved or mildly reduced ejection fraction

Relevant Reading: Association of Renin-Angiotensin Inhibitor Treatment With Mortality and Heart Failure Readmission in Patients With Transcatheter Aortic Valve Replacement

In-Depth [retrospective cohort]: This study was a retrospective analysis of prospectively collected data from the RASTAVI (Renin-Angiotensin System Blockade Benefits in Clinical Evolution and Ventricular Remodeling After Transcatheter Aortic Valve Implantation) registry. The study included 2866 consecutive patients undergoing TAVR for severe AS at 10 institutions. Patients were considered to be on RAS inhibition if they were on one of the following medications at discharge: angiotensin converting enzyme inhibitors, angiotensin-receptor blockers (with or without sacubitril), spironolactone or eplerenone. Those who died during the index hospitalization were excluded from analysis.

Of the 2785 patients included in the study 1622 were discharged on RAS inhibitor therapy. Following adjustment for baseline differences, there was no observed difference in overall mortality (14.5% vs. 15.3% in patients taking and not taking RAS inhibitors, respectively; p = 0.577), but RAS inhibition was linked with lower cardiac mortality at 3 years (9.3% vs. 5.6%; p < 0.001). At 3 years of follow-up 85.5% had echocardiographic re-evaluation with those on RAS inhibitors having greater reduction in ventricular volume and septal hypertrophy (p < 0.001).

Image: PD

©2019 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: ACE inhibitorsarbEplerenoneRAS inhibitorspironolactonetavr
Previous Post

Intensive blood pressure management reduces risk of recurrent stroke

Next Post

Adults with cerebral palsy at increased risk for mental health disorders

RelatedReports

Multiple opioid prescriptions associated with higher hospital admissions
Gastroenterology

Commonly cited medication triggers may not increase risk of microscopic colitis among older adults

July 4, 2025
Cardiology

Spironolactone ineffective for patients with preserved ejection fraction after myocardial infarction

March 4, 2025
Quick Take: Association of Rivaroxaban With Thromboembolic Events in Patients With Heart Failure, Coronary Disease, and Sinus Rhythm
Cardiology

Mineralocorticoid receptor antagonists reduce hospitalizations in patients with heart failure with preserved or mildly reduced ejection fraction

October 18, 2024
Imaging biomarkers may improve prediction of aortic valve stenosis
Cardiology

Novel transcatheter heart valve may be effective for management of high-risk aortic regurgitation

May 2, 2024
Next Post
Quick Take: Prevalence and Treatment of Depression, Anxiety, and Conduct Problems in US Children

Adults with cerebral palsy at increased risk for mental health disorders

Prenatal antidepressant exposure may increase risk of poor motor development

2 Minute Medicine Rewind August 5, 2019

Quick Take: Association of Prenatal Exposure to Air Pollution with Autism Spectrum Disorder

Pivotal response treatment improves social communication in children with autism spectrum disorder

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Living in a marginalized neighbourhood is associated with worse outcomes in patients with myocardial infarction
  • SGLT2 inhibitors may delay cognitive impairment in elderly patients with heart failure
  • Nerandomilast slows decline in FVC in idiopathic pulmonary fibrosis
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.