{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:35:18Z","timestamp":1777588518019,"version":"3.51.4"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,9,6]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Previous data suggest that using renin\u2010angiotensin\u2010aldosterone system inhibitors (RAASIs) improves survival in patients with cardiovascular diseases. We sought to investigate the association of different patterns of use of RAASIs on perioperative and 1\u2010year outcomes following carotid revascularization.<\/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\">\n              We investigated patients undergoing carotid revascularization, either with carotid endarterectomy or transfemoral carotid artery stenting, in the VQI (Vascular Quality Initiative) VISION (Vascular Implant Surveillance and Interventional Outcomes Network) data set between 2003 and 2018. We divided our cohort into 3 groups: (1) no history of RAASI intake, (2) preoperative intake only, and (3) continuous pre\u2010 and postoperative intake. The final cohort included 73\u2009174 patients; 44.4% had no intake, 50% had continuous intake, and 5.6% had only preoperative intake. Compared with continuous intake, preoperative and no intake were associated with higher odds of postoperative stroke (odds ratio [OR], 1.7 [95% CI, 1.5\u20131.9];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; OR, 1.1 [95% CI, 1.03\u20131.2];\n              <jats:italic>P<\/jats:italic>\n              =0.010); death (OR, 4.8 [95% CI, 3.8\u20136.1];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; OR, 1.9 [95% CI, 1.6\u20132.2];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); and stroke\/death (OR, 2.05 [95% CI, 1.8\u20132.3];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; OR, 1.2 [95% CI, 1.1\u20131.3];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), respectively. At 1\u2009year, preoperative and no intake were associated with higher odds of stroke (hazard ratio [HR], 1.4 [95% CI, 1.3\u20131.6];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; HR, 1.15, [95% CI, 1.08\u20131.2];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); death (HR, 1.7 [95% CI, 1.5\u20131.9];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; HR, 1.3 [95% CI, 1.2\u20131.4];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001); and stroke\/death (HR, 1.5 [95% CI, 1.4\u20131.7];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; HR, 1.2 [95% CI, 1.17\u20131.3];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), respectively.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Compared with subjects discontinuing or never starting RAASIs, use of RAASIs before and after carotid revascularization was associated with a short\u2010term stroke and mortality benefit. Future clinical trials examining prescribing patterns of RAASIs should aim to clarify the timing and potential to maximize the protective effects of RAASIs in high\u2010risk vascular patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.025034","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T09:02:34Z","timestamp":1661331754000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Role of Renin\u2010Angiotensin\u2010Aldosterone System Inhibition in Patients Undergoing Carotid Revascularization"],"prefix":"10.1161","volume":"11","author":[{"given":"Nadin","family":"Elsayed","sequence":"first","affiliation":[{"name":"Division of Vascular and Endovascular Surgery University of California San Diego La Jolla CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Unkart","sequence":"additional","affiliation":[{"name":"Department of Surgery State University New York Downstate University Health Sciences University Brooklyn NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Abdelgawwad","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery University of California San Diego La Jolla CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac","family":"Naazie","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery University of California San Diego La Jolla CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter\u00a0F.","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Department of Surgery David Geffen School of Medicine at UCLA Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2865-4079","authenticated-orcid":false,"given":"Mahmoud 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