Linggen Gao1, Lei Chen2, Li Fan3, Dewei Gao4, Zhiru Liang4, Rong Wang5, Wenning Lu4. 1. Department of Comprehensive Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China. Electronic address: gaolinggen@163.com. 2. Department of Thoracic Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China. 3. Department of Geriatric Cardiology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China. 4. Department of Comprehensive Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China. 5. Department of Comprehensive Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China. Electronic address: wangrong6969@126.com.
Abstract
OBJECTIVE: To assess the effect of losartan therapy on progressive aortic dilatation and on clinical outcome in patients with Marfan's syndrome (MFS). METHODS: The meta-analysis was instituted, which included studies identified by a systematic review of MEDLINE of peer-reviewed publications. Echocardiogram or MRI measurements of the aortic root dimension and outcome measures of death, cardiovascular surgery and aortic dissection or rupture were compared between patients who were treated and untreated with losartan therapy. RESULTS: Six randomized trials with 1398 subjects met all the inclusion criteria and were included in the meta-analysis. Compared with non-losartan treatment, losartan therapy significantly decreased the rate of aortic dilatation (SMD=-0.13 with 95% CI -0.25 to 0.00, p=0.04). The clinical outcome beneficial was not observed in the losartan treatment group when compared with no losartan treatment group (odds ratio=1.04 with 95% CI of 0.57-1.87). CONCLUSION: Given the current results of the meta-analysis and together with the lack of associated side effects, it would be reasonable to use losartan in MFS patients with aortic root dilatation. However, no clinical outcome benefits were observed in the losartan treatment group when compared with no losartan treatment group.
OBJECTIVE: To assess the effect of losartan therapy on progressive aortic dilatation and on clinical outcome in patients with Marfan's syndrome (MFS). METHODS: The meta-analysis was instituted, which included studies identified by a systematic review of MEDLINE of peer-reviewed publications. Echocardiogram or MRI measurements of the aortic root dimension and outcome measures of death, cardiovascular surgery and aortic dissection or rupture were compared between patients who were treated and untreated with losartan therapy. RESULTS: Six randomized trials with 1398 subjects met all the inclusion criteria and were included in the meta-analysis. Compared with non-losartan treatment, losartan therapy significantly decreased the rate of aortic dilatation (SMD=-0.13 with 95% CI -0.25 to 0.00, p=0.04). The clinical outcome beneficial was not observed in the losartan treatment group when compared with no losartan treatment group (odds ratio=1.04 with 95% CI of 0.57-1.87). CONCLUSION: Given the current results of the meta-analysis and together with the lack of associated side effects, it would be reasonable to use losartan in MFSpatients with aortic root dilatation. However, no clinical outcome benefits were observed in the losartan treatment group when compared with no losartan treatment group.
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