Navigation Links
Common blood pressure drug reduces aortic enlargement in Marfan syndrome
Date:9/2/2013

AMSTERDAM, The Netherlands - A common drug that is used to treat high blood pressure in the general population has been found to significantly reduce a dangerous and frequently fatal cardiac problem in patients with Marfan syndrome.

Results of the COMPARE (COzaar in Marfan PAtients Reduces aortic Enlargement) study reveal that patients treated with losartan (Cozaar) had a significantly reduced rate of aortic enlargement after 3 years compared to patients who did not receive the treatment.

"Our study is the first large, prospective randomized study to assess the effects of losartan on aortic enlargement in adults with Marfan syndrome, and confirms previous findings in a mouse model," said lead investigator Maarten Groenink MD, PhD from the Departments of Cardiology and Radiology at Academic Medical Centre in Amsterdam, The Netherlands.

"We're very excited to see that such a commonly used drug that is not expensive and has a familiar side-effect profile could have a significant effect on this very serious and frightening risk factor for these patients. These findings may change standard clinical management."

Marfan syndrome, a heritable connective tissue disorder, affects 2-3 in 10,000 people. It causes progressive enlargement of the aorta, making it prone to rupture, which can be fatal in more than 50% of cases. Currently, the only effective treatment is prophylactic surgical aortic root replacement.

In addition to lowering blood pressure, the main benefit of losartan is believed to be its interference with the biochemical process that causes aortic enlargement.

To assess this, the COMPARE study included 233 participants (47% female) with Marfan syndrome from all four academic Marfan screening centers in the Netherlands.

Subjects were a mean age of 41 years, 27% had previously undergone prophylactic aortic root replacement, and the majority (73%) were being treated with beta blockers.

A total of 117 subjects were randomized to receive no further treatment, while 116 were randomized to receive losartan 50 mg daily, doubling after 14 days if there were no side effects.

Aortic enlargement was monitored with magnetic resonance imaging (MRI) for three years of follow-up.

During the study period, if patients in either arm required prophylactic aortic root replacement the decision was left to the discretion of the attending cardiologists based on existing guidelines and anticoagulation therapy was initiated when appropriate.

The study showed that after 3 years aortic root enlargement was significantly less in the losartan group than in controls (0.77 mm vs. 1.35 mm, p=0.014), and 50% of losartan patients showed no growth of the aortic root compared to 31% of controls (p=0.022).

In Marfan syndrome aortic enlargement is usually confined to the 'aortic root', but may also extend beyond it. The study showed that aortic enlargement beyond the root was not significantly reduced by losartan. However, among the subset of patients who had already received aortic root replacement, dilation in one section, called the aortic arch, was significantly lower in patients treated with losartan compared to controls (0.50 mm vs. 1.01 mm; p=0.033). "This result should be interpreted with some caution as baseline aortic dimensions of patients with prior aortic root replacement were not completely comparable between the groups, " said Dr. Groenink.

Although the reduced rate of aortic enlargement in the losartan group suggests this drug may postpone or even prevent aortic rupture as well as the need for prophylactic surgery in Marfan patients, the study did not actually demonstrate this result.

There were no differences in the rate of aortic dissections (0 in the losartan group and 2 controls) or elective aortic surgery (10 in the losartan group and 9 in controls) and no cardiovascular deaths occurred.

"The incidence of clinical events was low in our study and therefore the clinical relevance of losartan treatment on aortic surgery and aortic dissection could not be determined," said Dr. Groenink, adding that only a larger prospective trial with longer follow-up can ultimately determine this outcome.


'/>"/>

Contact: ESC Press Office
press@escardio.org
44-773-005-7146
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. Common Lies About Diet and Nutrition and Advice for Choosing High Quality Foods: Gianluca Tognon Announces a New e-Book Published on His Website
2. Common genes may underlie alcohol dependence, eating disorders
3. Common Warts Removal Guide Published Online by eHealthMax.com
4. Household Germ Study Finds Common Kitchen Items Harbor E. coli, Salmonella, Listeria, Yeast and Mold
5. Commonly used catheters safety tied to patient population
6. GetKombucha.com Releases Extract That Solves Five Common Problems with Kombucha
7. Savannah Hyundai and SCAD Have Something In Common: They are Leaders in Design!
8. Isolated psychiatric episodes rare, but possible, in common form of autoimmune encephalitis
9. Medicationdiscountcard.com Issues Advisory: Health Insurance Plans Do Not Cover Many Common Prescription Medications
10. An important discovery at the Montreal Heart Institute: A new approach to treat the most common heart valve disease in Western countries
11. Hospital quality information on common heart procedure now publicly available
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/27/2017)... ... February 27, 2017 , ... ... last week. In addition, Discount Power's RCE (Residential Customer Equivalent) count exceeds ... 2014. The company had 800 customers and 2,250 RCEs at the time of ...
(Date:2/26/2017)... ... February 25, 2017 , ... The February 13, 2017, assassination of Kim ... over nerve agents and the deadly use of chemical weapons. Many questions exist about ... even small doses can be lethal. , Jay Jagannathan, M.D., of Michigan-based Jagannathan Neurosurgical ...
(Date:2/26/2017)... ... February 26, 2017 , ... IndustryArchive.Org . is announcing a new ... B2B Sellers will now only pay for B.A.N.T. quality sales leads based on the ... said, “Given the new reality that B2B buyers are controlling the sales process via ...
(Date:2/25/2017)... Viejo, CA (PRWEB) , ... February 25, 2017 , ... ... with ProSharpen Color tools from Pixel Film Studios. With ProSharpen Color users have total ... sliders to easily refine their color range. With color spectrum tools users can visually ...
(Date:2/24/2017)... ... February 24, 2017 , ... An in-depth computational analysis of genetic variants implicated ... to eight genes that may explain why susceptibility to one of the disorders could ... study published today in the journal npj Schizophrenia. , “There is a wealth ...
Breaking Medicine News(10 mins):
(Date:2/27/2017)...  International Biophysics Corporation, a global medical device manufacturer based ... 34% revenue growth in 2016 when compared to the previous ... growth was fueled by its AffloVest® sales in ... of its global sales of surgical product lines. ... enter our 25 th year in delivering high-quality, innovative ...
(Date:2/27/2017)... , Feb. 27, 2017  RegeneRx Biopharmaceuticals, ... clinical-stage drug development company focused on tissue protection, ... for RGN-137, GtreeBNT Co., Ltd., received a positive ... 3 clinical trial design for RGN-137 to treat ... healing gel that incorporates Thymosin beta 4 ("Tß4") ...
(Date:2/27/2017)... Leading Countries, Technologies and Companies The global ... CAGR of 8.9% from 2016-2021 and CAGR of 9.2% from 2021-2027. ... from 2016 to 2027. The market is estimated at $816m in ... ... to discover how you can exploit the future business opportunities emerging ...
Breaking Medicine Technology: