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Effect of valsartan added to background ACE inhibitor therapy in patients with heart failure: results from Val‐HeFT
Author(s) -
Krum Henry,
Carson Peter,
Farsang Csaba,
Maggioni Aldo P.,
Glazer Robert D.,
Aknay Nora,
Chiang YannTong,
Cohn Jay N.
Publication year - 2004
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.09.005
Subject(s) - valsartan , medicine , heart failure , ejection fraction , cardiology , sacubitril , placebo , ace inhibitor , aldosterone , angiotensin converting enzyme , blood pressure , alternative medicine , pathology
Aims To investigate the effect of valsartan in the Valsartan‐Heart Failure Trial (Val‐HeFT) when added to angiotensin‐converting enzyme inhibitor (ACEi) alone in patients with heart failure (HF). Methods Subjects in Val‐HeFT receiving ACEi but not beta‐blocker at baseline were analysed; 1532 were assigned to valsartan and 1502 assigned to placebo. Primary outcome events (all‐cause mortality, hospitalisation for adjudicated heart failure, sudden death with resuscitation and need for >4 h of parenteral therapy for worsening heart failure) were monitored. Results Mortality was not affected by valsartan but morbidity endpoints were significantly reduced (36.3% in placebo, 31.0% in valsartan, p =0.002) in patients receiving an ACEi but no beta‐blocker. Quality of life (QOL) was significantly improved, ejection fraction (EF) significantly increased, left ventricular (LV) diameter significantly reduced and plasma B‐type natriuretic peptide, norepinephrine and aldosterone levels significantly reduced with valsartan compared to placebo. The morbidity benefit was significant in patients on ACEi doses below the median (22% reduction, p =0.003) and not statistically significant in those receiving ACEi doses above the median (14% reduction, p =0.143). Conclusion Valsartan reduces heart failure hospitalisations and slows LV remodelling in patients treated with an ACEi in the absence of beta‐blockade, particularly in those on lower doses of ACEi.