Author + information
- Tomoki Ochiai,
- Shigeru Saito,
- Futoshi Yamanaka,
- Koki Shishido,
- Yutaka Tanaka,
- Shinichi Shirai,
- Norio Tada,
- Motoharu Araki,
- Toru Naganuma,
- Yusuke Watanabe,
- Masanori Yamamoto and
- Kentaro Hayashida
Background: In patients who underwent surgical aortic valve replacement for severe aortic stenosis, postoperative renin-angiotensin system (RAS) blockade therapy with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) has been shown to reduce left ventricular (LV) hypertrophy and improve survival, but its effect after transcatheter aortic valve implantation (TAVI) remains unclear. This study sought to investigate the effect of RAS blockade therapy on LV hypertrophy and mortality in patients undergoing TAVI.
Methods: Between October 2013 and April 2016, 1215 patients undergoing TAVI at any of nine participating centers were prospectively enrolled in the OCEAN-TAVI registry. This cohort was stratified according to postoperative usage of RAS blockade therapy with ACEIs or ARBs. Patients who had at least two prescriptions dispensed 180 days apart and at least a 6-month follow-up constituted the RAS blockade group (n=371), while those not prescribed any ACEIs or ARBs were included in the no RAS blockade group (n=189). LV mass index regression and all-cause mortality were analyzed.
Results: At 6 months postoperatively, there was significantly greater LV mass index regression in the RAS blockade group than in the no RAS blockade group (-7±22% vs. -2±24%, p=0.037). After adjusting for confounding factors, RAS blockade therapy was associated with significantly lower all-cause mortality (hazard ratio: 0.45; 95% confidence interval: 0.22 to 0.91; p=0.025).
Conclusions: In patients undergoing TAVI for severe aortic stenosis, postoperative RAS blockade therapy should be considered, as it is associated with greater LV mass index regression and reduced all-cause mortality.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 4
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1283-148
- 2017 American College of Cardiology Foundation