Key result
Planned trial evaluates captopril versus atenolol or placebo for reducing thoracic aortic aneurysm expansion.
Why the study?
Thoracic aortic aneurysms carry significant mortality and morbidity, but no therapy is effective at limiting aneurysm expansion and preventing rupture.
Does captopril or atenolol reduce the expansion rate of thoracic aortic aneurysms compared to placebo?
RCT (n=636)
parallel
Does captopril or atenolol reduce the expansion rate of thoracic aortic aneurysms compared to placebo?
This trial will determine whether captopril or atenolol is effective in reducing the expansion rate of thoracic aortic aneurysms compared to placebo.
Planned RCT will test whether ACE inhibition or beta-blockade slows thoracic aortic aneurysm expansion; leaves open whether medical therapy alters progression.
Thoracic aortic aneurysms are correlated with significant mortality and morbidity. No therapy, however, is effective at limiting aneurysm expansion and preventing rupture. Angiotensin-converting enzyme inhibitors can reduce the wall shear stress and inflammation, both of which play vital roles in the expansion of the aneurysm. A total of 636 patients will be randomized into one of three parallel arms, receiving captopril, atenolol or placebo. The primary end point will be the rate of change in the absolute diameter of the aortic root and ascending aorta on MRI of the aorta after 36 months. The trial will investigate the efficacy of angiotensin-converting enzyme inhibitors versus beta-blocker therapy in reducing the growth rate of thoracic aortic aneurysms and rupture. Trial registration number: NCT04224675
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Spartalis et al. (2020) conducted an RCT in Thoracic aortic aneurysms (n=636). Captopril vs. Atenolol or placebo was evaluated on Rate of change in the absolute diameter of the aortic root and ascending aorta on MRI after 36 months. This rationale and design paper describes a planned randomized trial of 636 patients to evaluate captopril versus atenolol or placebo for reducing thoracic aortic aneurysm expansion over 36 months.
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