Effect of the Angiotensin Receptor Blocker Valsartan on Morbidity and Mortality in Heart Failure: the Valsartan Heart Failure Trial (Val-HeFT)
2000; Lippincott Williams & Wilkins; Volume: 102; Issue: 21 Linguagem: Inglês
10.1161/01.cir.102.21.2672-b
ISSN1524-4539
Autores Tópico(s)Cardiac pacing and defibrillation studies
ResumoHomeCirculationVol. 102, No. 21Effect of the Angiotensin Receptor Blocker Valsartan on Morbidity and Mortality in Heart Failure: the Valsartan Heart Failure Trial (Val-HeFT) Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessOtherPDF/EPUBEffect of the Angiotensin Receptor Blocker Valsartan on Morbidity and Mortality in Heart Failure: the Valsartan Heart Failure Trial (Val-HeFT) Jay N. Cohn and Gianni Tognoni Jay N. CohnJay N. Cohn for the Val-HeFT Investigators, Minneapolis, Minnesota and Milan, Italy and Gianni TognoniGianni Tognoni for the Val-HeFT Investigators, Minneapolis, Minnesota and Milan, Italy Originally published21 Nov 2000https://doi.org/10.1161/01.CIR.102.21.2672-bCirculation. 2000;102:2672In order to assess the efficacy of the angiotensin receptor blocker valsartan in the treatment of heart failure (HF), 5010 patients were studied in 16 countries on 4 continents. Patients with chronic HF [NYHA II (62%), III (36%) and IV (2%)], ejection fraction (EF) 2.9 cm/m2 were randomly assigned to receive placebo (P) or valsartan (V) (titrated to 160 mg BID) in addition to all other appropriate therapy including ACE inhibitors (93%), beta blockers (36%), diuretics (86%) and digoxin (67%). Primary end-points were all-cause mortality (M) and mortality plus morbidity (M+M), which included hospitalization for heart failure (adjudicated), cardiac arrest with resuscitation, or need for intravenous support for worsening heart failure. Time to death was similar in the two groups but time to first M+M event was significantly reduced by 13.3% by V (32.1% in P, 28.8% in V; P=0.009). HF hospitalization was significantly reduced by 27.5% by V (18.5% in P, 13.9% in V; (P<0.001). The benefit of V on M+M was particularly prominent in patients not taking a beta blocker (37.0% to 30.8%, P<0.001) and in those not taking an ACE inhibitor (42.5% to 24.9%, P<0.001). The benefit on M+M was accompanied by significant improvements in NYHA class, quality of life, and EF. These data demonstrate clinical efficacy of valsartan in heart failure in patients already receiving standard HF therapy. eLetters(0) eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate. Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page. 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Goineau S, Nisse-Durgeat S, Pape D, Guillo P, Ramée M and Bellissant E (2002) Systemic and Regional Hemodynamic and Cardiac Remodeling Effects of Candesartan in Dilated Cardiomyopathic Hamsters With Advanced Congestive Heart Failure, Journal of Cardiovascular Pharmacology, 10.1097/00005344-200208000-00004, 40:2, (189-200), Online publication date: 1-Aug-2002. Schwartzkopff B, Fassbach M, Pelzer B, Brehm M and Strauer B (2002) Elevated serum markers of collagen degradation in patients with mild to moderate dilated cardiomyopathy, European Journal of Heart Failure, 10.1016/S1388-9842(02)00092-2, 4:4, (439-444), Online publication date: 1-Aug-2002. Patel A and Konstam M (2002) Recent Advances in the Treatment of Heart Failure, Circulation Journal, 10.1253/circj.66.117, 66:2, (117-121), . Wilson Tang W, Vagelos R, Yee Y, Benedict C, Willson K, Liss C, LaBelle P and Fowler M (2002) Neurohormonal and clinical responses to high- versus low-dose enalapril therapy in chronic heart failure, Journal of the American College of Cardiology, 10.1016/S0735-1097(01)01714-4, 39:1, (70-78), Online publication date: 1-Jan-2002. Alejandro Salomone Ó (2002) Los péptidos natriuréticos en la insuficiencia cardíaca: mejorando el diagnóstico y el manejo del síndrome, Revista Española de Cardiología, 10.1016/S0300-8932(02)76546-9, 55:1, (4-6), Online publication date: 1-Jan-2002. Trujillo-Santos A, Poveda-Gómez F and García-Alegría J (2002) Papel de los antagonistas del receptor de la angiotensina II en el tratamiento de la insuficiencia cardíaca, Medicina Clínica, 10.1016/S0025-7753(02)72381-6, 118:9, (347-352), Online publication date: 1-Jan-2002. Strehlow K, Böhm M and Nickenig G (2002) Besonderheiten der Herzinsuffizienz bei Frauen Die koronare Herzkrankheit der Frau, 10.1007/978-3-642-57534-1_17, (192-207), . Sica D and Elliott W (2007) Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Combination: Theory and Practice, The Journal of Clinical Hypertension, 10.1111/j.1524-6175.2001.00678.x, 3:6, (383-387), Online publication date: 1-Nov-2001. Andersen N and Mogensen C (2016) Review: Inhibition of the renin-angiotensin system, with particular reference to dual blockade treatment, Journal of the Renin-Angiotensin-Aldosterone System, 10.3317/jraas.2001.020, 2:3, (146-152), Online publication date: 1-Sep-2001. Richer C, Fornes P, Domergue V, De Gasparo M and Giudicelli J (2001) Combined angiotensin II AT1-receptor blockade and angiotensin I–converting enzyme inhibition on survival and cardiac remodeling in chronic heart failure in rats, Journal of Cardiac Failure, 10.1054/jcaf.2001.26312, 7:3, (269-276), Online publication date: 1-Sep-2001. Opie L and Sack M (2001) Enhanced Angiotensin II Activity in Heart Failure , Circulation Research, 88:7, (654-658), Online publication date: 13-Apr-2001. November 21, 2000Vol 102, Issue 21 Advertisement Article Information Metrics Copyright © 2000 by American Heart Associationhttps://doi.org/10.1161/01.CIR.102.21.2672-b Originally publishedNovember 21, 2000 PDF download Advertisement
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