کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8651521 | 1572067 | 2018 | 6 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Relation Between Renin-Angiotensin System Blockers and Survival Following Isolated Aortic Valve Replacement for Aortic Stenosis
ترجمه فارسی عنوان
ارتباط بین مسدود کننده های سیستم رنین-آنژیوتانسین و زنده ماندن پس از تعویض سوپاپ جدا شده آئورت برای تنگی آئورت
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موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی
Renin-angiotensin system blockers (RASb) improve cardiac remodeling, but their clinical utility after surgical aortic valve replacement (SAVR) for aortic stenosis (AS) is unclear. We aimed to assess the impact of RASb on short- and long-term survival following isolated SAVR for severe AS. From January 2005 to January 2014, 508 consecutive patients had isolated SAVR for severe AS. Patients with RASb (nâ=â286; 53%) were more often female (pâ=â0.039), hypertensive (pâ<â0.0001), and diabetic (pâ=â0.004), with higher body mass index (pâ<â0.0001) and EuroSCORE II (pâ=â0.025), and lower mean aortic pressure gradient (pâ=â0.011). The 30-day mortality was similar in both groups (RASb: 3% vs no RASb: 5.8%, pâ=â0.13), but lower under angiotensin receptor blockers (ARB) than angiotensin-converting enzyme inhibitors (ACEi; 0.7% vs 5.6%, pâ=â0.017). Patients under RASb had a better 8-year survival than those without RASb (83â±â3% vs 52â±â5%, pâ<â0.0001), confirmed in a propensity score-matched pairs analysis (82â±â4% vs 50â±â7%, pâ<â0.0001). Regarding different types of RASb, patients under ARB had lower mortality than those under ACEi (87â±â3% vs 79â±â4%, pâ=â0.028). In multivariate analysis, the use of RASb was associated with improved survival (hazard ratioâ=â0.31, 95% confidence interval 0.20 to 0.47, pâ<â0.0001), with lower mortality under ARB than under ACEi (hazard ratioâ=â0.39, 95% confidence interval 0.18 to 0.85, pâ=â0.018). In this observational study, the use of RASb was associated with improved long-term outcome after isolated SAVR for severe AS. A randomized clinical trial is mandatory.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The American Journal of Cardiology - Volume 121, Issue 4, 15 February 2018, Pages 455-460
Journal: The American Journal of Cardiology - Volume 121, Issue 4, 15 February 2018, Pages 455-460
نویسندگان
Julien PhD, Barthélémy MD, Alexandre MD, Emmanuelle MD, Jean-Philippe MD, Dania MD, PhD, Victor MD, PhD,