Atherosclerosis is a risk factor for both aortic stenosis (AS) and coronary artery disease. This study aimed to investigate whether anti-atherosclerotic therapy (AT), defined as the simultaneous use of antiplatelet agents, statins, and renin aldosterone system inhibitors, had long-term clinical benefits for patients who underwent transcatheter aortic valve replacement (TAVR). Between October 2013 and May 2017, 2518 patients (31% men; median age, 85 years) who underwent TAVR in 14 Japanese centers were divided into two groups: patients who were prescribed anti-atherosclerotic therapy (AT, n = 567) and patients who were not (no AT, n = 1951). The median follow-up period for this cohort was 693 days (interquartile range, 389–870 days). Compared to no AT group, AT group was associated with significantly lower 2-year all-cause mortality (11.7% vs. 16.5%; log-rank p = 0.002) and 2-year cardiovascular mortality rates (3.5% vs. 6.0%; log-rank p = 0.017). In a propensity-matched cohort (n = 495 each; median follow-up, 710 days [IQR, 394 − 896 days]), patients in AT group had a lower prevalence of 2-year cardiovascular mortality (3.8% vs. 6.2%, log-rank p = 0.024) than that in the no AT group. In the multivariate stepwise regression analysis, AT was a significant predictor of cardiovascular mortality (hazard ratio 0.45; 95% confidence interval 0.25–0.80; p = 0.007). AT may improve survival in post-TAVR patients. Future studies are necessary to identify an optimal treatment regimen to improve long-term outcomes after TAVR.

动脉粥样硬化是主动脉瓣狭窄 (AS) 和冠状动脉疾病的危险因素。本研究旨在调查抗动脉粥样硬化治疗 (AT)，定义为同时使用抗血小板药物、他汀类药物和肾素醛固酮系统抑制剂，是否对接受经导管主动脉瓣置换术 (TAVR) 的患者具有长期临床益处。2013 年 10 月至 2017 年 5 月，在 14 个日本中心接受 TAVR 的 2518 名患者（31% 男性；中位年龄，85 岁）分为两组：接受抗动脉粥样硬化治疗的患者（AT，n  = 567）和谁不是（没有 AT，n = 1951）。该队列的中位随访期为 693 天（四分位距，389-870 天）。与无 AT 组相比，AT 组显着降低 2 年全因死亡率（11.7% 对 16.5%；对数秩p  = 0.002）和 2 年心血管死亡率（3.5% 对 6.0%；对数秩p  = 0.017）。在一个倾向匹配队列（每个n  = 495；中位随访时间，710 天 [IQR，394 - 896 天]）中，AT 组患者的 2 年心血管死亡率发生率较低（3.8% vs. 6.2% , log-rank p  = 0.024) 比没有 AT 组。在多元逐步回归分析中，AT 是心血管死亡率的显着预测因子（风险比 0.45；95% 置信区间 0.25-0.80；p = 0.007)。AT 可以提高 TAVR 后患者的生存率。未来的研究对于确定改善 TAVR 后长期结果的最佳治疗方案是必要的。