UNASSIGNED: A systematic search was performed in PubMed, Embase, and Cochrane library databases for relevant studies published before March 2022. Studies meeting the inclusion criteria were included to assess the effect of RASi on short-term (≤30 days) and long-term (≥1 year) mortality in patients with AS.
UNASSIGNED: A total of 11 studies were included in the meta-analysis. Our results demonstrated that RASi reduced short-term mortality (OR = 0.76, 95% CI 0.63-0.93, p = 0.008) after aortic valve replacement (AVR). Subgroup analysis revealed that RASi was still associated with lower short-term mortality after transcatheter aortic valve replacement (TAVR); however, the association was relatively weak in patients who underwent surgical aortic valve replacement (SAVR). For long-term mortality, the pooled OR was 1.04 (95% CI 0.88-1.24, p = 0.63) after sensitivity analysis in patients who did not undergo AVR. In addition, our study confirmed that RASi significantly reduced long-term mortality (OR = 0.57, 95% CI 0.44-0.74, p < 0.0001) in patients who underwent AVR. Subgroup analysis showed that both TAVR and SAVR groups treated with RASi had lower long-term mortality.
UNASSIGNED: Renin-angiotensin system inhibitors did not change long-term mortality in AS patients who did not undergo AVR. However, RASi reduced short- and long-term mortality in patients who underwent AVR.
未经评估:在PubMed中进行了系统搜索,Embase,和Cochrane图书馆数据库,用于2022年3月之前发表的相关研究。纳入符合纳入标准的研究,以评估RASi对AS患者短期(≤30天)和长期(≥1年)死亡率的影响。
未经评估:共有11项研究纳入荟萃分析。我们的结果表明,RASi降低了主动脉瓣置换术(AVR)后的短期死亡率(OR=0.76,95%CI0.63-0.93,p=0.008)。亚组分析显示,经导管主动脉瓣置换术(TAVR)后,RASi仍与较低的短期死亡率相关;然而,在接受外科主动脉瓣置换术(SAVR)的患者中,这种关联相对较弱.对于长期死亡率,对未接受AVR的患者进行敏感性分析后,合并OR为1.04(95%CI0.88~1.24,p=0.63).此外,我们的研究证实,RASi可显著降低AVR患者的长期死亡率(OR=0.57,95%CI0.44-0.74,p<0.0001).亚组分析显示,接受RASi治疗的TAVR和SAVR组均具有较低的长期死亡率。
UNASSIGNED:肾素-血管紧张素系统抑制剂未改变未接受AVR的AS患者的长期死亡率。然而,RASi降低了接受AVR的患者的短期和长期死亡率。