Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions.
Our mission is to improve the quality of life of the population by reducing the impact of cardiac rhythm disturbances and reduce sudden cardiac death.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
The ESC Councils' goal is to share knowledge among medical professionals practising in specific cardiology domains.
OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
Dr. Pedro Trigo Trindade
Dr. Maarten Groenink
Presenter abstractDiscussant reportAll the Scientific resources on ESC Congress 365
By Maarten GroeninkOther authors: MD Romy Franken, the NetherlandsMD Alexander den Hartog, the NetherlandsBackground:Patients with Marfan syndrome (MFS) have an increased risk of life-threatening aortic complications, mostly preceded by aortic dilatation. Recently, treatment with losartan showed reduction of the aortic dilatation rate in a MFS mouse model. The primary aim of our study was to determine whether losartan reduces aortic dilatation rate in humans with MFS.
Methods:In this multicenter, open-label, randomized controlled trial with blinded assessments, losartan was compared with no additional treatment in 233 adults with MFS. The primary endpoint was aortic dilatation rate at any aortic level as determined by magnetic resonance imaging after 3 years of follow-up. The secondary endpoint was the reduction of the incidence of cardiovascular mortality, aortic dissection or prophylactic aortic surgery. The effect of losartan on aortic dilatation rate was evaluated by covariance analysis with baseline aortic dimension as covariate.
Results:A total of 233 participants (47% female) underwent randomization to either losartan (n=116) or no additional treatment (n=117). Follow-up was 3.1±0.4 years, similar in both arms. Further results will be submitted separately because the manuscript is currently under review by the New England Journal of Medicine.
Conclusions:In this study we determined whether losartan treatment reduced aortic root dilatation rate in adult Marfan patients. Conclusion will be submitted separately.
Pedro Trigo TrindadeIn this HOTLINE session, Groenink et al (1) present the first prospective, multicentre, randomized, controlled trial indicating a beneficial effect of losartan in adults with Marfan syndrome (MFS). COMPARE (COzaar in Marfan PAtients Reduces Aortic Enlargement) was designed to test the hypothesis of whether losartan reduces the aortic dilatation rate at any of six predefined aortic levels in adults with MFS. Additional aims of the study were to examine the effect of losartan on aortic volume and incidence of aortic dissection, on elective aortic surgery or cardiovascular death.The authors enrolled 233 operated and unoperated patients who were randomized to losartan or no additional treatment. All previously prescribed medication, including beta-blockers and calcium channel blockers, was continued after inclusion. Importantly, by design the trial was open label with blinded assessment of endpoints. At baseline, patients would undergo magnetic resonance imaging (MRI) [or exceptionally computed tomography (CT)] of the entire aorta and again at 3 years of follow-up. Clinical assessment and transthoracic echocardiography were performed on an annual basis.The authors were able to evaluate the aortic root dilatation rate in 145 patients with a native aortic root, and show that after 3 years of follow-up, the aortic root dilatation rate was significantly lower in the losartan group compared with the control group, with a number-needed-to-treat of 5.3 patients. Furthermore, in patients with prior aortic root replacement, aortic arch dilatation rate was significantly lower in the losartan group.However, no significant differences in separate clinical endpoints or the composite clinical endpoint could be shown between groups.In summary, according to the results of COMPARE addition of losartan to standard care in Marfan patients should be advised. 1 - Groenink M, den Hartog AW, Franken M, Radonic T, de Waard V, Timmermans J, Scholte AJ, van den Berg MP, Spijkerboer AM, Marquering HA, Zwinderman AH, Mulder BJM. Eur Heart J 2013;
COMPARE: COMPARE: Effect of losartan on aortic dilatation rate in adults with Marfan Syndrome
© 2017 European Society of Cardiology. All rights reserved