VALsartan In Acute myocardial iNfarcTion (VALIANT) trial: baseline characteristics in context

被引:65
作者
Velazquez, EJ
Pfeffer, MA
McMurray, JV
Maggioni, AP
Rouleau, JL
Van de Werf, F
Kober, L
White, HD
Swedberg, K
Leimberger, JD
Gallo, P
Sellers, MA
Edwards, S
Henis, M
Califf, RM
机构
[1] Duke Univ, Ctr Med, Dept Med, Div Cardiol, Durham, NC 27715 USA
[2] Duke Clin Res Inst, Durham, NC 27715 USA
[3] Brigham & Womens Hosp, Div Cardiovasc, Boston, MA 02115 USA
[4] Univ Glasgow, Clin Res Initiat Heart Failure, Glasgow, Lanark, Scotland
[5] ANMCO, Res Ctr, Florence, Italy
[6] Univ Toronto, Div Cardiol, Toronto, ON, Canada
[7] Leuven Coordinating Ctr, Louvain, Belgium
[8] Rigshosp, Copenhagen, Denmark
[9] Green Lane Hosp, Auckland 3, New Zealand
[10] Sahlgrenska Hosp, Gothenburg, Sweden
[11] Nova Pharmaceut Corp, E Hanover, NJ USA
关键词
angiotensin-converting enzyme; angiotensin receptor blocker; myocardial infarction; left ventricular dysfunction; heart failure; prognosis;
D O I
10.1016/S1388-9842(03)00112-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial compared outcomes with: (1) angiotensin-converting enzyme inhibition (ACEI) with the reference agent captopril; (2) angiotensin-receptor blockade (ARB) with valsartan; or (3) both in patients with heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) after myocardial infarction (MI). Aims: a goal of this active-control trial was to simulate conditions that would lead current practitioners to use ACEIs. Thus, we compared characteristics of VALIANT patients with those of patients in placebo-controlled trials that established ACEIs as standard treatment. Methods and Results: we collected demographic, clinical, medication and imaging information from 14 703 patients in 24 countries. This high-risk population was a median 65.8 years old, and 31.1% were female. Most (51.8%) showed imaging evidence of LVSD at enrollment. Most (72%) had Killip class greater than or equal to II HF. Patients received evidence-based therapies at rates similar to those of contemporary MI trials and at an improved rate compared with prior placebo-controlled ACEI trials. Conclusion: VALIANT represents the largest globally representative cohort enrolled with HF and/or LVSD after MI. Patients were similar to those in placebo-controlled ACEI trials while reflecting improvements in evidence-based care. With enrollment complete, VALIANT is poised to define the optimal strategy for renin-angiotensin system blockade after MI to improve cardiovascular outcomes. (C) 2003 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:537 / 544
页数:8
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