Long-termclinical outcomes of valsartan in patientswith a systemic right ventricle

Autor: Barbara J.M. Mulder, Alexandra C. van Dissel, Teun van der Bom, Arie P.J. van Dijk, Jolien W. Roos-Hesselink, Aeilko H. Zwinderman, Gertjan T. Sieswerda, Berto J. Bouma, Hubert W. Vliegen, Petronella G. Pieper, Michiel M. Winter
Přispěvatelé: Cardiology, Graduate School, ACS - Heart failure & arrhythmias, ACS - Pulmonary hypertension & thrombosis, ACS - Amsterdam Cardiovascular Sciences, Epidemiology and Data Science, APH - Methodology, APH - Personalized Medicine, APH - Aging & Later Life, Cardiovascular Centre (CVC)
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Time Factors
Ventricular Dysfunction
Right
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
030204 cardiovascular system & hematology
law.invention
0302 clinical medicine
Randomized controlled trial
law
Clinical endpoint
Transposition of the great arteries
030212 general & internal medicine
Renin angiotensin aldosterone system
Tricuspid valve
Treatment Outcome
medicine.anatomical_structure
Valsartan
Great arteries
ENALAPRIL
Cardiology
SURVIVAL
HEART-FAILURE
Female
Cardiology and Cardiovascular Medicine
medicine.drug
Adult
medicine.medical_specialty
Randomization
Heart failure
Placebo
Drug Administration Schedule
Young Adult
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
ANGIOTENSIN RECEPTOR BLOCKADE
Internal medicine
medicine
Humans
Long-term follow-up
Antihypertensive Agents
Retrospective Studies
Congenital heart disease
business.industry
Systemic right ventricle
ADULTS
medicine.disease
DYSFUNCTION
TRANSPOSITION
business
Follow-Up Studies
Zdroj: International Journal of Cardiology, 278, 84-87. ELSEVIER IRELAND LTD
International Journal of Cardiology, 278, pp. 84-87
International Journal of Cardiology, 278, 84-87
International Journal of Cardiology, 278, 84-87. Elsevier Ireland Ltd
International journal of cardiology, 278, 84-87. Elsevier Ireland Ltd
ISSN: 0167-5273
DOI: 10.1016/j.ijcard.2018.11.027
Popis: Objectives: In the VAL-SERVE (Valsartan in Systemic Right Ventricle) trial, three-year valsartan treatment improved systemic ventricular function only in symptomatic patients with congenitally or with an atrial switch corrected transposition of the great arteries. The aim of the current study was to investigate the longer-term clinical outcomes after valsartan treatment.Methods: From 2006 to 2009, 88 adults were randomly allocated 1:1 to either valsartan or placebo for three consecutive years. Endpoints were defined as overall survival and freedom from clinical events (arrhythmia, heart failure, tricuspid valve surgery, death).Results: Cardiac drug use andmedian follow-up after trial close-out (8.3 years) was similar between the randomization groups. Six patients (valsartan n = 3, placebo n = 3) died in 364 and 365 person-years (P = 0.999). No difference in the composite or separate clinical endpoints was found between the randomization groups, with corresponding long-term event-free survival rates of 50% and 34%. Nevertheless, in symptomatic patients valsartan significantly reduced the risk for events compared to placebo (HR 0.37, 95% CI 0.17-0.92). Analysis for repeated events and on-treatment analysis with any renin-angiotensin-aldosterone-system-inhibitor did not alter these results.Conclusions: Valsartan treatment in systemic RV patients did not result in improved survival at longer-term follow-up, but was associated with decreased risk of events in symptomatic patients. (c) 2018 Elsevier B.V. All rights reserved.
Databáze: OpenAIRE
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