Valvular & structural heart disease
Renin-Angiotensin System Inhibition in Patients With Myocardial Injury Complicating Transcatheter Aortic Valve Replacement
Authors' conclusion
One out of 7 patients undergoing TAVR experienced periprocedural myocardial injury. VARC-3 periprocedural myocardial injury was associated with a 2-fold increased risk of cardiovascular death at 1 year after TAVR. The favorable association of RAS inhibitor prescription was consistent in patients with and without periprocedural myocardial injury.
Study context
- Population
- Patients undergoing transcatheter aortic valve replacement (TAVR), August 2007–June 2023
- Participants
- 2,083 patients
- Exposure
- Myocardial injury vs No injury
- Myocardial injuryn = 283
- Outcome
- Prevalence of myocardial injury and CV death
Methodological detailsSwissTAVI Registry, retrospectively stratified
- SwissTAVI Registry
- Retrospectively stratified
Main finding
As reported in the abstract
Periprocedural myocardial injury and CV death · 1 year
Myocardial injury
13.8%
283 of 283
Adjusted hazard ratio (95% CI)
Myocardial injury vs No injuryCV death at 1 year
2.08(1.39–3.11)
RAS inhibitors vs No RAS inhibitorsCV death, patients with myocardial injury
0.46(0.22–0.95)
RAS inhibitors vs No RAS inhibitorsCV death, patients without myocardial injury
0.44(0.30–0.65)
- Renin-angiotensin system (RAS) inhibitors prescribed, myocardial injury
- 197 (70%)
- RAS inhibitors prescribed, no injury
- 1,251 (71.2%)
Observational data: associations, not effects.
Original publication
Renin-Angiotensin System Inhibition in Patients With Myocardial Injury Complicating Transcatheter Aortic Valve Replacement. JACC Adv. Published 16 August 2024. doi:10.
Summarised from the published abstract; every number is checked against it