{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:09:37Z","timestamp":1788934177088,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients with aortic stenosis may continue to have an increased risk of heart failure, arrhythmias, and death after successful transcatheter aortic valve implantation. Renin\u2010angiotensin system inhibitors may be beneficial in this setting. We aimed to explore whether ramipril improves the outcomes of patients with aortic stenosis after transcatheter aortic valve implantation.<\/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              PROBE (Prospective Randomized Open, Blinded Endpoint) was a multicenter trial comparing ramipril with standard care (control) following successful transcatheter aortic valve implantation in patients with left ventricular ejection fraction &gt;40%. The primary end point was the composite of cardiac mortality, heart failure readmission, and stroke at 1\u2010year follow\u2010up. Secondary end points included left ventricular remodeling and fibrosis. A total of 186 patients with median age 83\u2009years (range 79\u201386), 58.1% women, and EuroSCORE\u2010II 3.75% (range 3.08\u20134.97) were randomized to receive either ramipril (n=94) or standard treatment (n=92). There were no significant baseline, procedural, or in\u2010hospital differences. The primary end point occurred in 10.6% in the ramipril group versus 12% in the control group (\n              <jats:italic>P<\/jats:italic>\n              =0.776), with no differences in cardiac mortality (ramipril 1.1% versus control group 2.2%,\n              <jats:italic>P<\/jats:italic>\n              =0.619) but lower rate of heart failure readmissions in the ramipril group (3.2% versus 10.9%,\n              <jats:italic>P<\/jats:italic>\n              =0.040). Cardiac magnetic resonance analysis demonstrated better remodeling in the ramipril compared with the control group, with greater reduction in end\u2010systolic and end\u2010diastolic left ventricular volumes, but nonsignificant differences were found in the percentage of myocardial fibrosis.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Ramipril administration after transcatheter aortic valve implantation in patients with preserved left ventricular function did not meet the primary end point but was associated with a reduction in heart failure re\u2010admissions at 1\u2010year follow\u2010up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique Identifier: NCT03201185.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.035460","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T09:29:05Z","timestamp":1726651745000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Ramipril After Transcatheter Aortic Valve Implantation in Patients Without Reduced Ejection Fraction: The RASTAVI Randomized Clinical Trial"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2311-4129","authenticated-orcid":false,"given":"Ignacio J.","family":"Amat\u2010Santos","sequence":"first","affiliation":[{"name":"Cardiology Department Hospital Cl\u00ednico Universitario de Valladolid Spain"},{"name":"CIBERCV (Centro de Investigaci\u00f3n biom\u00e9dica en red\u2010Enfermedades Cardiovasculares) Instituto de Salud Carlos III Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"L\u00f3pez\u2010Otero","sequence":"additional","affiliation":[{"name":"CIBERCV (Centro de Investigaci\u00f3n biom\u00e9dica en red\u2010Enfermedades Cardiovasculares) Instituto de Salud Carlos III Madrid Spain"},{"name":"Cardiology Department, IDIS Complejo Hospitalario Universitario de Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3438-8907","authenticated-orcid":false,"given":"Luis","family":"Nombela\u2010Franco","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Cl\u00ednico San Carlos Instituto de Investigaci\u00f3n Sanitaria Hospital Cl\u00ednico San Carlos (IdISSC) Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0379-5243","authenticated-orcid":false,"given":"Vicente","family":"Peral\u2010Disdier","sequence":"additional","affiliation":[{"name":"CIBERCV (Centro de Investigaci\u00f3n biom\u00e9dica en red\u2010Enfermedades Cardiovasculares) Instituto de Salud Carlos III Madrid Spain"},{"name":"Cardiology Department, Hospital Universitari Son Espases (HUSE) Institut d\u2019Investigaci\u00f3 Sanit\u00e0ria Illes Balears (IdISBa) Palma Balearic Islands Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6405-8581","authenticated-orcid":false,"given":"Enrique","family":"Guti\u00e9rrez\u2010Iba\u00f1es","sequence":"additional","affiliation":[{"name":"CIBERCV (Centro de Investigaci\u00f3n biom\u00e9dica en red\u2010Enfermedades Cardiovasculares) Instituto de Salud Carlos III Madrid Spain"},{"name":"Cardiology Department Hospital Gregorio Mara\u00f1on Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5271-1993","authenticated-orcid":false,"given":"Victor","family":"Jim\u00e9nez\u2010Diaz","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital \u00c1lvaro Cunqueiro University Hospital of Vigo Pontevedra Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Mu\u00f1oz\u2010Garcia","sequence":"additional","affiliation":[{"name":"CIBERCV (Centro de Investigaci\u00f3n biom\u00e9dica en red\u2010Enfermedades Cardiovasculares) Instituto de Salud Carlos III Madrid Spain"},{"name":"Cardiology Department Hospital Virgen de la Victoria M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7891-2913","authenticated-orcid":false,"given":"Raquel","family":"Del Valle","sequence":"additional","affiliation":[{"name":"CIBERCV (Centro de Investigaci\u00f3n biom\u00e9dica en red\u2010Enfermedades Cardiovasculares) Instituto de Salud Carlos III Madrid Spain"},{"name":"Cardiology Department Hospital U. 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