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Losartan for Preventing Aortic Root Dilatation in Patients with Marfan Syndrome: A Meta-Analysis of Randomized Trials
Journal article   Open access   Peer reviewed

Losartan for Preventing Aortic Root Dilatation in Patients with Marfan Syndrome: A Meta-Analysis of Randomized Trials

Ayman Elbadawi, Mohamed A. Omer, Islam Y. Elgendy, Ahmed Abuzaid, Ahmed H. Mohamed, Devesh Rai, Marwan Saad, Amgad Mentias, Ahmed Rezq, Diaa Kamal, …
Cardiology and therapy, Vol.8(2), pp.365-372
12/01/2019
DOI: 10.1007/s40119-019-00149-3
PMCID: PMC6828927
PMID: 31606871
url
https://europepmc.org/articles/pmc6828927View
Published (Version of record) Open Access

Abstract

Introduction The role of losartan in preventing aortic root dilatation in Marfan syndrome has been evaluated in many clinical trials; however, the results are conflicting. Methods We performed a computerized search of MEDLINE, EMBASE and COCHRANE databases through February 2019 for randomized clinical trials evaluating the effect of losartan in patients with Marfan syndrome. The main outcome was the change in the aortic root diameter in the losartan versus control groups. Results Our final analysis included seven randomized trials with a total of 1352 patients and average weighted follow-up of 37.8 months. Change in aortic root diameter was significantly smaller with losartan compared with control [weighted means: 0.44 vs. 0.58 mm, mean difference (MD) = -0.13; 95% CI -0.24 to -0.02; p = 0.02]. Subgroup analysis according to the control group showed no significant subgroup interaction when comparing losartan with beta-blockers versus with standard therapy (p(interaction=) 0.27). The composite outcome of aortic surgery, dissection or mortality did not differ between the losartan and control groups (risk ratio = 1.03; 95% CI 0.72-1.49, p = 0.86). Conclusion In this meta-analysis including seven randomized trials, the use of losartan was associated with a significantly smaller change in aortic root diameter in patients with Marfan syndrome.
Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Science & Technology

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