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Valsartan: in chronic heart failure.

Keri Wellington1, Karen L Goa

  • 1Adis International Inc., Langhorne, Pennsylvania 19047, USA. demail@adis.com

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
|January 20, 2004
PubMed
Summary

Valsartan, an angiotensin II receptor blocker, reduced heart failure morbidity and mortality in patients intolerant to ACE inhibitors. However, it showed increased mortality in a subgroup also taking ACE inhibitors and beta-blockers.

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Valsartan is an angiotensin II (AII) receptor antagonist approved for heart failure (HF) patients intolerant to ACE inhibitors.
  • The Valsartan Heart Failure Trial (Val-HeFT) evaluated valsartan in chronic heart failure (CHF).

Purpose of the Study:

  • To assess the efficacy and safety of valsartan in patients with heart failure.
  • To evaluate valsartan's impact on mortality and morbidity endpoints in CHF.

Main Methods:

  • A randomized, placebo-controlled trial (Val-HeFT) involving 5010 patients with CHF (NYHA class II-IV).
  • Patients received valsartan 160 mg twice daily plus conventional therapy or placebo.
  • Subgroup analyses were performed based on concomitant ACE inhibitor and beta-blocker use.

Main Results:

  • Valsartan reduced the combined endpoint of mortality and morbidity by 13.2% compared to placebo in the overall CHF population.
  • In patients not receiving ACE inhibitors, valsartan significantly decreased mortality risk (33.1%) and combined endpoint risk (44%), with fewer hospitalizations.
  • In the subgroup on both ACE inhibitors and beta-blockers, valsartan was associated with significantly higher mortality.

Conclusions:

  • Valsartan is effective in reducing morbidity and mortality in specific heart failure populations, particularly those intolerant to ACE inhibitors.
  • Caution is advised when using valsartan in combination with ACE inhibitors and beta-blockers due to increased mortality risk in that subgroup.

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