Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
A Bayesian Meta-Analysis of Renin-Angiotensin System Inhibitors Following TAVR.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Oliveira Vinícius Martins Rodrigues, Barbosa Lucas M, Sousa Pedro Antônio de, Lima Ana Paula Duarte, Akabane Maria Antonia Cruz, Borges Arthur, Bertoli Edmundo Damiani, Bulhões Elísio, Farias Carlos Alexandre, Mazetto Roberto, Tartuce Filho Paulo Roberto Ferreira, Alcântara Robert Willian Anastácio, Bignoto Tiago, Pileggi Brunna, Moreira Humberto Graner, Tartuce Ludimilla Pereira
Аннотация
BACKGROUND: Aortic stenosis leads to left ventricular remodeling, hypertrophy, and fibrosis, increasing the risk of heart failure. Renin-angiotensin system (RAS) inhibitors may mitigate these adverse effects and improve clinical outcomes. Despite advancements in transcatheter aortic valve replacement (TAVR), substantial mortality, heart failure readmissions, and other complications persist.
AIMS: This study aimed to evaluate the impact of RAS inhibitor therapy following TAVR on clinical outcomes.
METHODS: We conducted a systematic review and Bayesian meta-analysis following the Cochrane Handbook for Systematic Reviews of Interventions. A comprehensive search of PubMed, Embase, and Cochrane was performed to identify studies comparing RAS inhibitor (RASi) use versus non-use in patients undergoing TAVR for aortic stenosis. Odds ratios (OR) and 95% credible intervals (CrI) were estimated using a Bayesian random-effects model. Between-study heterogeneity was quantified using the posterior distribution of the heterogeneity parameter (τ). Posterior probabilities (PP) of treatment benefit were calculated, with clinically meaningful effects defined as P (OR < 0.8). All analyses were performed using R version 4.5.0.
RESULTS: A total of 12 studies comprising 35,988 patients were included, of whom 17,026 (47.3%) received RASi therapy. The mean age ranged from 78.9 to 84.4 years. Post-TAVR RASi use was associated with a 79.4% probability of a clinically relevant reduction in all-cause mortality and a 99.5% probability of a clinically relevant reduction in cardiovascular mortality. There was a 54% probability of a clinically relevant reduction in heart failure hospitalization and a negligible (2.26%) probability of a reduction in the odds of myocardial infarction in the RASi group.
CONCLUSIONS: RASi therapy following TAVR is associated with reduced odds of mortality and heart failure readmission.
AIMS: This study aimed to evaluate the impact of RAS inhibitor therapy following TAVR on clinical outcomes.
METHODS: We conducted a systematic review and Bayesian meta-analysis following the Cochrane Handbook for Systematic Reviews of Interventions. A comprehensive search of PubMed, Embase, and Cochrane was performed to identify studies comparing RAS inhibitor (RASi) use versus non-use in patients undergoing TAVR for aortic stenosis. Odds ratios (OR) and 95% credible intervals (CrI) were estimated using a Bayesian random-effects model. Between-study heterogeneity was quantified using the posterior distribution of the heterogeneity parameter (τ). Posterior probabilities (PP) of treatment benefit were calculated, with clinically meaningful effects defined as P (OR < 0.8). All analyses were performed using R version 4.5.0.
RESULTS: A total of 12 studies comprising 35,988 patients were included, of whom 17,026 (47.3%) received RASi therapy. The mean age ranged from 78.9 to 84.4 years. Post-TAVR RASi use was associated with a 79.4% probability of a clinically relevant reduction in all-cause mortality and a 99.5% probability of a clinically relevant reduction in cardiovascular mortality. There was a 54% probability of a clinically relevant reduction in heart failure hospitalization and a negligible (2.26%) probability of a reduction in the odds of myocardial infarction in the RASi group.
CONCLUSIONS: RASi therapy following TAVR is associated with reduced odds of mortality and heart failure readmission.