{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:35:54Z","timestamp":1778733354175,"version":"3.51.4"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,12,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Sepsis is known to increase morbidity and duration of hospital stay and is a common cause of mortality worldwide. Renin\u2010angiotensin\u2010aldosterone system inhibitors (RAASis) are commonly used to treat hypertension but are usually discontinued during hospitalization for sepsis because of concerns about renal hypoperfusion. The aim of our study was to investigate whether RAASis should be continued after discharge in sepsis survivors and to identify the effects on the clinical outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">A total of 9188 sepsis survivors aged 20\u00a0years and older who were discharged from January 1, 2012 to December 31, 2019 were included in our analyses. We further divided sepsis survivors into RAASi users and nonusers. These groups were matched by propensity scores before the outcomes of interest, including all\u2010cause mortality and major adverse cardiac events (MACE), were examined. After propensity score matching, 3106 RAASi users and 3106 RAASi nonusers were included in our analyses. Compared with RAASi nonusers, RAASi users had lower risks of all\u2010cause mortality (hazard ratio [HR], 0.68; 95% CI, 0.62\u20130.75), MACEs (HR, 0.87; 95% CI, 0.81\u20130.94), ischemic stroke (HR, 0.85; 95% CI, 0.76\u20130.96), myocardial infarction (HR, 0.74; 95% CI, 0.61\u20130.90), and hospitalization for heart failure (HR, 0.84; 95% CI, 0.77\u20130.92). Subgroup analyses stratified by admission to the ICU and the use of inotropes showed similar results.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In our study, we found that RAASi users had reduced risks of all\u2010cause mortality and MACEs. These findings suggested a beneficial effect of RAASi use by sepsis survivors after discharge.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.022870","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T19:11:24Z","timestamp":1638299484000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Effects of Renin\u2010Angiotensin\u2013Aldosterone System Inhibitors on Long\u2010Term Major Adverse Cardiovascular Events in Sepsis Survivors"],"prefix":"10.1161","volume":"10","author":[{"given":"Shu\u2010Yu","family":"Ou","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Kaohsiung Veterans General Hospital Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi\u2010Jung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine Taipei City Hospital, Ren\u2010Ai Branch Taipei Taiwan"},{"name":"School of Medicine National Yang\u2010Ming University Taipei Taiwan"},{"name":"School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Kaohsiung Veterans General Hospital Kaohsiung Taiwan"},{"name":"School of Medicine National Defense Medicine Center Taipei Taiwan"},{"name":"School of Nursing Fooyin University Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen\u2010Hsiu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Kaohsiung Veterans General Hospital Kaohsiung Taiwan"},{"name":"School of Medicine National Yang\u2010Ming University Taipei Taiwan"},{"name":"School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Chi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Kaohsiung Veterans General Hospital Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Ting","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Kaohsiung Veterans General Hospital Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3418-8008","authenticated-orcid":false,"given":"Yuan\u2010Yi","family":"Chia","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Kaohsiung Veterans General Hospital Kaohsiung Taiwan"},{"name":"School of Medicine National Yang\u2010Ming University Taipei Taiwan"},{"name":"School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan"},{"name":"School of Medicine National Defense Medicine Center Taipei Taiwan"},{"name":"School of Nursing Fooyin University Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.45"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2016.01.002"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004230050090"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1189\/jlb.0912437"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/emmm.201000080"},{"issue":"5","key":"e_1_3_1_8_2","first-page":"S19","article-title":"Role of angiotensin ii in blood pressure regulation and in the pathophysiology of cardiovascular disorders","volume":"9","author":"Fyhrquist F","year":"1995","unstructured":"Fyhrquist F, Mets\u00e4rinne K, Tikkanen I. 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