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VALIANT (VALsartan In Acute myocardial iNfarcTion) trial

Aldo Pietro Maggioni1, Gianna Fabbri

  • 1ANMCO Research Center, Via La Marmora 34, 50121 Florence, Italy. maggioni@anmco.it

Expert Opinion on Pharmacotherapy
|March 30, 2005
PubMed

Insights

Valsartan, an angiotensin receptor blocker, is a viable alternative to ACE inhibitors for patients with heart failure or left ventricular dysfunction after myocardial infarction. The VALIANT trial found no significant difference in mortality or adverse cardiovascular events between valsartan and captopril.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Angiotensin-converting enzyme inhibitors (ACE-Is) are standard treatment post-myocardial infarction (MI) for heart failure (HF) or left ventricular systolic dysfunction.
  • Complete renin-angiotensin system blockade via angiotensin type 1 receptor blockade presents a potential alternative.

Purpose of the Study:

  • To evaluate valsartan, captopril, or their combination in post-MI patients with HF or left ventricular systolic dysfunction.
  • To compare the efficacy and safety of valsartan versus ACE-I in this patient population.

Main Methods:

  • The VALIANT trial randomized post-MI patients with HF or systolic dysfunction to receive valsartan, captopril, or both.
  • Patients were followed for a median of 24.7 months.

Main Results:

  • No significant differences in total mortality or the composite endpoint of cardiovascular death, MI, or HF were observed among the three treatment groups.
  • Valsartan demonstrated non-inferiority to captopril regarding total mortality and cardiovascular death, MI, and HF.

Conclusions:

  • Valsartan can be considered a safe and effective alternative to ACE-Is for patients with post-MI HF or left ventricular systolic dysfunction.
  • Angiotensin type 1 receptor blockade offers a comparable therapeutic option to ACE-I in this high-risk population.

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