Document Detail


Effect of valsartan added to background ACE inhibitor therapy in patients with heart failure: results from Val-HeFT.
MedLine Citation:
PMID:  15556056     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To investigate the effect of valsartan in the Valsartan-Heart Failure Trial (Val-HeFT) when added to angiotensin-converting enzyme inhibitor (ACEi) alone in patients with heart failure (HF).
METHODS: Subjects in Val-HeFT receiving ACEi but not beta-blocker at baseline were analysed; 1532 were assigned to valsartan and 1502 assigned to placebo. Primary outcome events (all-cause mortality, hospitalisation for adjudicated heart failure, sudden death with resuscitation and need for >4 h of parenteral therapy for worsening heart failure) were monitored.
RESULTS: Mortality was not affected by valsartan but morbidity endpoints were significantly reduced (36.3% in placebo, 31.0% in valsartan, p=0.002) in patients receiving an ACEi but no beta-blocker. Quality of life (QOL) was significantly improved, ejection fraction (EF) significantly increased, left ventricular (LV) diameter significantly reduced and plasma B-type natriuretic peptide, norepinephrine and aldosterone levels significantly reduced with valsartan compared to placebo. The morbidity benefit was significant in patients on ACEi doses below the median (22% reduction, p=0.003) and not statistically significant in those receiving ACEi doses above the median (14% reduction, p=0.143).
CONCLUSION: Valsartan reduces heart failure hospitalisations and slows LV remodelling in patients treated with an ACEi in the absence of beta-blockade, particularly in those on lower doses of ACEi.
Authors:
Henry Krum; Peter Carson; Csaba Farsang; Aldo P Maggioni; Robert D Glazer; Nora Aknay; Yann-Tong Chiang; Jay N Cohn
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of heart failure     Volume:  6     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-11-23     Completed Date:  2006-05-16     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  937-45     Citation Subset:  IM    
Affiliation:
Monash University Medical School, Alfred Hospital, Melbourne, Australia. henry.mrum@med.monash.edu.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  adverse effects,  therapeutic use*
Antihypertensive Agents / administration & dosage,  adverse effects,  therapeutic use*
Blood Pressure / drug effects
Death, Sudden, Cardiac / epidemiology,  etiology
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Heart Failure / drug therapy*,  mortality,  physiopathology
Heart Rate / drug effects
Humans
Male
Middle Aged
Quality of Life
Risk Factors
Single-Blind Method
Stroke Volume / drug effects
Survival Analysis
Tetrazoles / administration & dosage,  adverse effects,  therapeutic use*
Treatment Outcome
Valine / administration & dosage,  adverse effects,  analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine
Comments/Corrections
Comment In:
Evid Based Cardiovasc Med. 2005 Jun;9(2):115-6   [PMID:  16380005 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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