{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:35:05Z","timestamp":1790685305574,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003793","name":"Swedish Heart-Lung Foundation","doi-asserted-by":"publisher","award":["20210433"],"award-info":[{"award-number":["20210433"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Swedish Heart-Lung Foundation","doi-asserted-by":"publisher","award":["ALFGBG-977905"],"award-info":[{"award-number":["ALFGBG-977905"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p\/>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>Current clinical guidelines have no specific recommendations regarding medical therapy after surgical aortic valve replacement in patients with aortic regurgitation (AR). We studied the association between medical therapy with renin\u2013angiotensin system (RAS) inhibitors, statins and \u03b2-blockers and long-term major adverse cardiovascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>All patients undergoing valve replacement due to AR between 2006 and 2017 in Sweden and alive 6 months after discharge were included. Time-dependent multivariable Cox regression models adjusted for age, sex, patient characteristics, comorbidities, other medications and year of surgical aortic valve replacement were used. Primary outcome was a composite of all-cause mortality, myocardial infarction and stroke. Subgroup analyses based on age, sex, heart failure, low ejection fraction, hyperlipidaemia and hypertension were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 2204 patients were included [median follow-up 5.0\u2009years (range 0.0\u201311.5)]. At baseline, 68% of the patients were dispensed RAS inhibitors, 80% \u03b2-blockers and 35% statins. Dispense of RAS inhibitors and \u03b2-blockers declined over time, especially during the first year after baseline, while dispense of statins remained stable. Treatment with RAS inhibitors or statins was associated with a reduced risk of the primary outcome [adjusted hazard ratio (aHR) 0.71, 95% confidence interval (CI) 0.57\u20130.87 and aHR 0.78, 95% CI 0.62\u20130.99, respectively]. The results were consistent in subgroups based on age, sex and comorbidities. \u03b2-Blocker treatment was associated with an increased risk for the primary outcome (aHR 1.35, 95% CI 1.07\u20131.70).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The results indicate a potential beneficial association of RAS inhibitors and statins as part of a secondary preventive treatment regime after aortic valve replacement in patients with AR. The role of \u03b2-blockers needs to be further investigated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad042","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T17:08:10Z","timestamp":1675703290000},"source":"Crossref","is-referenced-by-count":6,"title":["Medical therapy after surgical aortic valve replacement for aortic regurgitation"],"prefix":"10.1093","volume":"63","author":[{"given":"Charlotta","family":"T\u00f6rngren","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sahlgrenska University Hospital , Gothenburg, Sweden"},{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6689-6976","authenticated-orcid":false,"given":"Kristjan","family":"Jonsson","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sahlgrenska University Hospital , Gothenburg, Sweden"},{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma C","family":"Hansson","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sahlgrenska University Hospital , Gothenburg, Sweden"},{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg , Sweden"},{"name":"Department of Cardiology, Sahlgrenska University Hospital , Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2356-2295","authenticated-orcid":false,"given":"Anders","family":"Jeppsson","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Sahlgrenska University Hospital , Gothenburg, Sweden"},{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1461-0777","authenticated-orcid":false,"given":"Andreas","family":"Martinsson","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg , Sweden"},{"name":"Department of Cardiology, Sahlgrenska University Hospital , Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"2023051908112474000_ezad042-B1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1161\/CIRCULATIONAHA.104.488825","article-title":"Valvular heart disease: aortic regurgitation","volume":"112","author":"Bekeredjian","year":"2005","journal-title":"Circulation"},{"key":"2023051908112474000_ezad042-B2","doi-asserted-by":"crossref","first-page":"3515","DOI":"10.1093\/eurheartj\/ehw229","article-title":"Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: the OxVALVE Population Cohort Study","volume":"37","author":"d'Arcy","year":"2016","journal-title":"Eur Heart J"},{"key":"2023051908112474000_ezad042-B3","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1016\/S0002-9149(98)01064-9","article-title":"Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study)","volume":"83","author":"Singh","year":"1999","journal-title":"Am J Cardiol"},{"key":"2023051908112474000_ezad042-B4","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1161\/01.CIR.99.14.1851","article-title":"Mortality and morbidity of aortic regurgitation in clinical practice. 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