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April 12, 2026Journal of Clinical MedicineOpen Access

Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients Undergoing Aortic Valve Replacement for Severe Aortic Stenosis: A Retrospective Cohort Study

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Why the study?

Does preoperative ACEi/ARB use reduce one-year all-cause mortality in patients undergoing aortic valve replacement for severe aortic stenosis?

Population

198 consecutive patients with severe aortic stenosis undergoing transcatheter or surgical aortic valve…

Comparison

Preoperative use of angiotensin-converting… vs No preoperative ACEi/ARB therapy

Design

Cohort

Follow-up

1 year

Authors

HAHusnain AbidYKYusuf KhanNKN K Khan

Discussion

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Overview

Preoperative ACEi/ARB use in patients undergoing aortic valve replacement appears safe and is associated with numerically lower unadjusted mortality, though this finding was not statistically significant after multivariable adjustment.

Key Points

  • This study investigates the association between preoperative ACEi/ARB use and one-year mortality after aortic valve replacement in patients with severe aortic stenosis.
  • Conducted a retrospective cohort study of 198 patients undergoing transcatheter or surgical aortic valve replacement.
  • Analyzed preoperative ACEi/ARB therapy and its effects on one-year mortality.
  • Utilized multivariable logistic regression for adjustment of confounding factors.
  • 40% of patients were on preoperative ACEi/ARB therapy.
  • Unadjusted one-year mortality was lower in the ACEi/ARB group at 7% compared to 19%.
  • After multivariable adjustment, the association with mortality did not reach statistical significance.

Structured PICO

Does preoperative ACEi/ARB use reduce one-year all-cause mortality in patients undergoing aortic valve replacement for severe aortic stenosis?

P
Population
198 consecutive patients with severe aortic stenosis undergoing transcatheter (TAVI) or surgical aortic valve replacement (SAVR) at a single tertiary centre.
I
Intervention
Preoperative use of angiotensin-converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs)
C
Comparator
No preoperative ACEi/ARB therapy
O
Outcome
One-year all-cause mortalityhard clinical

Preoperative ACEi/ARB use in patients undergoing aortic valve replacement appears safe and is associated with numerically lower unadjusted mortality, though this finding was not statistically significant after multivariable adjustment.

Limitations

  • small sample size
  • residual confounding cannot be excluded
  • single-centre observational study
  • absence of adjustment for confounders in subgroup analysis

Cite This Study

Abid et al. (2026) studied this question.

synapsesocial.com/papers/69db37044fe01fead37c4ff9https://doi.org/10.3390/jcm15082904
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