Key result
Valsartan is as effective as an ACE inhibitor in reducing mortality and morbidity in high-risk post-myocardial infarction survivors with left ventricular systolic dysfunction and/or heart failure.
Why the study?
Does valsartan reduce mortality and morbidity in high-risk post-myocardial infarction survivors with left ventricular systolic dysfunction and/or heart failure?
Does valsartan reduce mortality and morbidity in high-risk post-myocardial infarction survivors with left ventricular systolic dysfunction and/or heart failure?
Valsartan is as effective as ACE inhibitors for secondary prevention in high-risk post-MI survivors with LV systolic dysfunction or heart failure.
Valsartan may serve as an ACE inhibitor alternative in high-risk post-MI LV dysfunction; leaves open need for contemporary head-to-head trials.
Survivors of myocardial infarction (MI) are at high risk of disability and death. This is due to infarct-related complications such as heart failure, cardiac remodeling with progressive ventricular dilation, dysfunction, and hypertrophy, and arrhythmias including ventricular and atrial fibrillation. Angiotensin (Ang) II, the major effector molecule of the renin-angiotensin-aldosterone system (RAAS) is a major contributor to these complications. RAAS inhibition, with angiotensin-converting enzyme (ACE) inhibitors were first shown to reduce mortality and morbidity after MI. Subsequently, angiotensin receptor blockers (ARBs), that produce more complete blockade of the effects of Ang II at the Ang II type 1 (AT1) receptor, were introduced and the ARB valsartan was shown to be as effective as an ACE inhibitor in reducing mortality and morbidity in high-risk post-MI survivors with left ventricular (LV) systolic dysfunction and and/or heart failure and in heart failure patients, respectively, in two major trials (VALIANT and Val-HeFT). Both these trials used an ACE inhibitor as comparator on top of background therapy. Evidence favoring the use of valsartan for secondary prevention in post-MI survivors is reviewed.
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Bodh I. Jugdutt (2006) conducted a review in Myocardial infarction with left ventricular systolic dysfunction and/or heart failure. Valsartan vs. ACE inhibitors (e.g., captopril) was evaluated. Valsartan is as effective as an ACE inhibitor in reducing mortality and morbidity in high-risk post-myocardial infarction survivors with left ventricular systolic dysfunction and/or heart failure.
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