Table 1. Baseline Characteristics Before and After Propensity Score Matching.
| Characteristics | Before Propensity Score Matching | SMD | After Propensity Score Matchinga | SMD | ||
|---|---|---|---|---|---|---|
| RAS Inhibitor Prescription (n = 8468) |
No Prescription (n = 12 844) |
RAS Inhibitor Prescription (n = 7948) |
No Prescription (n = 7948) |
|||
| Angiotensin-converting enzyme inhibitor, No. (%) | ||||||
| Taking one | 5641 (66.6) | 0 | 5249 (66.0) | 0 | ||
| Had contraindication to use | 85 (1.0) | 467 (3.6) | 79 (1.0) | 264 (3.3) | ||
| Angiotensin II receptor blocker, No. (%) | ||||||
| Taking one | 2956 (34.9) | 0 | 2820 (35.5) | 0 | ||
| Had contraindication to use | 27 (0.3) | 51 (0.4) | 25 (0.3) | 33 (0.4) | ||
| Age, mean (SD), y | 82.3 (6.8) | 82.9 (6.9) | −0.0797 | 82.4 (6.8) | 82.4 (6.9) | 0.004 |
| Body mass index, mean (SD)b | 28.4 (6.6) | 27.8 (6.4) | 0.0848 | 28.3 (6.6) | 28.3 (6.6) | −0.003 |
| Sex, No. (%) | ||||||
| Female | 3983 (47.0) | 6087 (47.4) | −0.0069 | 3792 (47.7) | 3847 (48.4) | 0.378 |
| Male | 4485 (53.0) | 6757 (52.6) | 4156 (52.3) | 4101 (51.6) | ||
| Society of Thoracic Surgeons Predicted Risk of Mortality scorec | ||||||
| Mean (SD), % | 7.4 (5.0) | 8.3 (6.1) | −0.1566 | 7.5 (5.1) | 7.5 (5.0) | 0.004 |
| <4% (low risk), No. (%) | 1935 (22.9) | 2663 (20.7) | 0.1335 | 1792 (22.5) | 1813 (22.8) | 0.02 |
| 4%-<8% (intermediate risk), No. (%) | 3778 (44.6) | 5306 (41.3) | 3528 (44.4) | 3509 (44.1) | ||
| 8%-<15% (high risk), No. (%) | 2108 (24.9) | 3478 (27.1) | 1996 (25.1) | 2040 (25.7) | ||
| ≥15% (prohibitive risk), No. (%) | 647 (7.6) | 1397 (10.9) | 632 (8.0) | 586 (7.4) | ||
| Medical history, No. (%) | ||||||
| CABG surgery | 2515 (29.7) | 3251 (25.3) | 0.0989 | 2286 (28.8) | 2269 (28.5) | 0.005 |
| Aortic valve procedure | 1041 (12.3) | 1737 (13.5) | −0.0368 | 993 (12.5) | 996 (12.5) | −0.001 |
| Permanent pacemaker or ICD | 1539 (18.2) | 2484 (19.3) | −0.0298 | 1415 (17.8) | 1443 (18.2) | −0.009 |
| Atrial fibrillation or flutter | 3358 (39.7) | 5657 (44.0) | −0.0896 | 3180 (40.0) | 3165 (39.8) | 0.003 |
| Stroke | 1052 (12.4) | 1510 (11.8) | 0.0204 | 979 (12.3) | 1004 (12.6) | −0.01 |
| Transient ischemic attack | 759 (9.0) | 1145 (8.9) | 0.0019 | 718 (9.0) | 720 (9.1) | <0.001 |
| Peripheral arterial disease | 2585 (30.5) | 3807 (29.6) | 0.019 | 2424 (30.5) | 2421 (30.5) | <0.001 |
| Hypertension | 7950 (93.9) | 11 289 (87.9) | 0.2091 | 7439 (93.6) | 7403 (93.1) | 0.02 |
| Diabetes mellitus | 3371 (39.8) | 4377 (34.1) | 0.1185 | 3077 (38.7) | 3074 (38.7) | <0.001 |
| Chronic lung disease | 2090 (24.7) | 3516 (27.4) | −0.0629 | 1980 (24.9) | 1959 (24.6) | 0.005 |
| Myocardial infarction | 2104 (24.8) | 2966 (23.1) | 0.0414 | 1920 (24.2) | 1905 (24.0) | 0.005 |
| Triple vessel disease | 2348 (27.7) | 3226 (25.1) | 0.0608 | 2135 (26.9) | 2117 (26.6) | 0.006 |
| Left main disease | 885 (10.5) | 1206 (9.4) | 0.0358 | 799 (10.1) | 800 (10.1) | <0.001 |
| NYHA class within 2 wk prior to hospital admission, No. (%)d | ||||||
| I or II (mild limitation) | 1643 (19.4) | 2402 (18.7) | −0.0175 | 1547 (19.5) | 1559 (19.6) | 0.004 |
| III or IV (severe limitation) | 6766 (79.9) | 10 332 (80.4) | 6349 (79.9) | 6315 (79.5) | ||
| 5-meter walk test, No. (%) | ||||||
| ≤6 s (normal) | 1715 (20.3) | 2445 (19.0) | 0.0481 | 1598 (20.1) | 1551 (19.5) | 0.02 |
| >6-10 s (slow) | 3036 (35.9) | 4454 (34.7) | 2852 (35.9) | 2813 (35.4) | ||
| >10 s (slowest or unable to walk) | 2454 (29.0) | 3922 (30.5) | 2316 (29.1) | 2387 (30.0) | ||
| Walk test not performed | 1253 (14.8) | 2000 (15.6) | 1174 (14.8) | 1178 (14.8) | ||
| Estimated glomerular filtration rate, mL/min/1.73 m2 | ||||||
| Mean (SD) | 64.5 (24.4) | 60.3 (26.5) | 0.165 | 63.8 (24.4) | 63.5 (24.9) | 0.01 |
| <30 (or receiving dialysis), No. (%) | 446 (5.3) | 1365 (10.6) | 0.2206 | 444 (5.6) | 442 (5.6) | 0.01 |
| 30-<60, No. (%) | 3371 (39.8) | 5378 (41.9) | 3266 (41.1) | 3230 (40.6) | ||
| ≥60, No. (%) | 4634 (54.7) | 6081 (47.3) | 4222 (53.1) | 4257 (53.6) | ||
| Hemoglobin, mean (SD), g/dL | 12.0 (1.9) | 11.8 (1.9) | 0.1243 | 12.0 (1.9) | 12.0 (1.9) | 0.001 |
| Albumin, mean (SD), g/dL | 3.7 (0.5) | 3.7 (0.5) | 0.1088 | 3.7 (0.5) | 3.7 (0.5) | 0.01 |
| Preprocedure echocardiogram | ||||||
| LVEF, mean (SD), % | 51.1 (12.1) | 52.6 (10.8) | −0.1306 | 51.9 (11.5) | 52.0 (11.5) | −0.002 |
| LVEF ≤40%, No. (%) | 1795 (21.2) | 2078 (16.2) | 0.1281 | 1477 (18.6) | 1477 (18.6) | <0.001 |
| LV systolic diameter, mean (SD), cm | 3.3 (1.0) | 3.2 (0.9) | 0.1079 | 3.3 (0.9) | 3.3 (0.9) | 0.005 |
| LV diastolic diameter, mean (SD), cm | 4.7 (0.9) | 4.6 (0.9) | 0.1157 | 4.6 (0.9) | 4.6 (0.8) | 0.006 |
| Postprocedure echocardiogram, No./total No. (%) | ||||||
| Moderate or severe aortic regurgitation | 313/7168 (4.4) | 529/11 014 (4.8) | −0.0252 | 292/6744 (4.3) | 289/6801 (4.2) | <0.001 |
| Moderate or severe mitral regurgitation | 1145/7168 (16.0) | 2065/11 014 (18.7) | −0.0767 | 1096/6744 (16.3) | 1063/6801 (15.6) | 0.005 |
| β-Blocker at hospital discharge, No. (%) | 5908 (69.8) | 8725 (67.9) | 0.0399 | 5475 (68.9) | 5502 (69.2) | −0.007 |
| Complication during hospitalization, No. (%) | ||||||
| Myocardial infarction | 18 (0.2) | 25 (0.2) | 0.0041 | 17 (0.2) | 11 (0.1) | 0.02 |
| Stroke | 130 (1.5) | 230 (1.8) | −0.0199 | 124 (1.6) | 135 (1.7) | −0.01 |
| Vasculare | 314 (3.7) | 533 (4.2) | −0.0228 | 304 (3.8) | 309 (3.9) | −0.003 |
| New requirement for dialysis | 6 (0.1) | 96 (0.7) | −0.1056 | 6 (0.1) | 3 (0) | 0.02 |
Abbreviations: CABG, coronary artery bypass graft; ICD, implantable cardioverter-defibrillator; LV, left ventricular; LVEF, left ventricular ejection fraction; NYHA, New York Heart Association; RAS, renin-angiotensin system; SMD, standardized mean difference.
To account for differences between those discharged from the hospital with a prescription for a RAS inhibitor vs those discharged from the hospital with no prescription, 1:1 propensity score matching was performed. A logistic regression model was used to estimate the propensity for prescription of a RAS inhibitor. Covariates in the model included baseline characteristics and demographics, coronary anatomical information, echocardiographic findings before and after transcatheter aortic valve replacement, medications at hospital discharge, and in-hospital adverse events. The entire list of covariates appears in eAppendix 2 in the Supplement.
Calculated as weight in kilograms divided by height in meters squared.
Estimates the potential risk for operative mortality (range, 0%-100%); a higher score indicates an increased risk.
Categorizes patients based on how much they are limited during physical activity.
Defined according to the Valve Academic Research Consortium-2 consensus document. The detailed definition appears in eAppendix 4 in the Supplement.