Effect of valsartan added to background ACE inhibitor therapy in patients with heart failure: Results from Val-HeFT

Henry Krum, Peter Carson, Csaba Farsang, Aldo P. Maggioni, Robert D. Glazer, Nora Aknay, Yann Tong Chiang, Jay N. Cohn

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92 Citations (Scopus)

Abstract

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). 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. 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). 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.

Original languageEnglish
Pages (from-to)937-945
Number of pages9
JournalEuropean journal of heart failure
Volume6
Issue number7
DOIs
Publication statusPublished - Dec 1 2004

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Keywords

  • ACE-inhibition
  • Angiotensin receptor blockade
  • Chronic heart failure
  • Mortality
  • Valsartan

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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