June 21, 2005Circulation
Changes in Ventricular Size and Function in Patients Treated With Valsartan, Captopril, or Both After Myocardial Infarction
Key result
Treatment with valsartan, captopril, or their combination resulted in similar changes in cardiac volume, ejection fraction, and infarct segment length at 20 months after myocardial infarction.
Why the study?
Does valsartan alone or in combination with captopril improve left ventricular enlargement or ejection fraction to a greater extent than captopril alone in patients after myocardial infarction with left ventricular dysfunction or heart failure?
Population
610 patients who experienced myocardial infarction and evidence of left ventricular dysfunction, heart…
Comparison
Valsartan 160 mg PO BID or valsartan 80 mg PO… vs Captopril 50 mg PO TID
Design
RCT, randomized
Follow-up
20 months
Authors
Discussion
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Implication
Valsartan is a comparable alternative to captopril for post-MI remodeling; confirms no incremental benefit from combination therapy.
Key Points
- This study aims to compare the effects of valsartan and captopril on left ventricular size and function after myocardial infarction.
- Randomized trial involving 610 patients with myocardial infarction and left ventricular dysfunction.
- Patients received valsartan, captopril, or a combination of both starting 1-10 days after MI.
- Echocardiographic measures were taken at baseline and 20 months to assess changes in cardiac function.
- Changes in left ventricular size and function were similar across all treatment groups after 20 months.
- Echocardiographic measures at baseline predicted outcomes like mortality and heart failure hospitalizations.
- No significant difference found between valsartan, captopril, or their combination.
Study Design
Type
RCT (n=610)
Randomization
Randomized
Structured PICO
Does valsartan alone or in combination with captopril improve left ventricular enlargement or ejection fraction to a greater extent than captopril alone in patients after myocardial infarction with left ventricular dysfunction or heart failure?
P
Population
610 patients with myocardial infarction and evidence of LV dysfunction or heart failure, randomized 1 to 10 days post-MI and followed for 20 months.
I
Intervention
Valsartan 160 mg PO BID or valsartan 80 mg PO BID plus captopril 50 mg PO TID started between 1 and 10 days after MI
C
Comparator
Captopril 50 mg PO TID
O
Outcome
Changes in echocardiographic measures (ventricular volumes, ejection fractions, combined areas, and infarct segment length) from baseline to 20 monthssurrogate
In patients with post-MI left ventricular dysfunction or heart failure, valsartan, captopril, and their combination have similar effects on attenuating progressive left ventricular remodeling over 20 months.
Cite This Study
Solomon et al. (2005) conducted an RCT in Myocardial infarction with LV dysfunction or heart failure (n=610). Valsartan, captopril, or both vs. Compared among the three arms was evaluated on Changes in echocardiographic measures (ventricular volumes, ejection fractions, combined areas, and infarct segment length) from baseline to 20 months. Treatment with valsartan, captopril, or their combination resulted in similar changes in cardiac volume, ejection fraction, and infarct segment length at 20 months after myocardial infarction.