Marfan Sartan: a randomized, double-blind, placebo-controlled trial - Archive ouverte HAL Access content directly
Journal Articles European Heart Journal Year : 2015

Marfan Sartan: a randomized, double-blind, placebo-controlled trial

, (1, 2) , (3) , (4, 5) , (1) , , (6, 1) , (7, 8) , (9) , (10) , , , , , , (11) , (12) , (13) , (14) , (15) , (16, 17, 18) , (19) , (20) , (21) , (22)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
Olivier Milleron
  • Function : Author
Gabriel Delorme
  • Function : Author
Sophie Dupuis-Girod
  • Function : Author
  • PersonId : 950963
Martine Barthelet
  • Function : Author
Francois Sassolas
  • Function : Author
Nicolas Pangaud
  • Function : Author
Sophie Naudion
  • Function : Author
Julie Thomas-Chabaneix
  • Function : Author
Gilbert Habib
Guillaume Jondeau
  • Function : Author
  • PersonId : 865480

Abstract

Aims - To evaluate the benefit of adding Losartan to baseline therapy in patients with Marfan syndrome (MFS). Methods and results - A double-blind, randomized, multi-centre, placebo-controlled, add on trial comparing Losartan (50 mg when <50 kg, 100 mg otherwise) vs. placebo in patients with MFS according to Ghent criteria, age >10 years old, and receiving standard therapy. 303 patients, mean age 29.9 years old, were randomized. The two groups were similar at baseline, 86% receiving β-blocker therapy. The median follow-up was 3.5 years. The evolution of aortic diameter at the level of the sinuses of Valsalva was not modified by the adjunction of Losartan, with a mean increase in aortic diameter at the level of the sinuses of Valsalva of 0.44 mm/year (s.e. = 0.07) (-0.043 z/year, s.e. = 0.04) in patients receiving Losartan and 0.51 mm/year (s.e. = 0.06) (-0.01 z/year, s.e. = 0.03) in those receiving placebo (P = 0.36 for the comparison on slopes in millimeter per year and P = 0.69 for the comparison on slopes on z-scores). Patients receiving Losartan had a slight but significant decrease in systolic and diastolic blood pressure throughout the study (5 mmHg). During the study period, aortic surgery was performed in 28 patients (15 Losartan, 13 placebo), death occurred in 3 patients [0 Losartan, 3 placebo, sudden death (1) suicide (1) oesophagus cancer (1)]. Conclusion - Losartan was able to decrease blood pressure in patients with MFS but not to limit aortic dilatation during a 3-year period in patients >10 years old. β-Blocker therapy alone should therefore remain the standard first line therapy in these patients.

Dates and versions

hal-01201942 , version 1 (18-09-2015)

Identifiers

Cite

Olivier Milleron, Florence Arnoult, Jacques Ropers, Philippe Aegerter, Delphine Detaint, et al.. Marfan Sartan: a randomized, double-blind, placebo-controlled trial. European Heart Journal, 2015, 36 (32), pp.2160--2166. ⟨10.1093/eurheartj/ehv151⟩. ⟨hal-01201942⟩
203 View
0 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More