Journal article
Meta-analysis Examining the Usefulness of Angiotensin Receptor blockers for the Prevention of Aortic Root Dilation in Patients With the Marfan Syndrome
The American journal of cardiology, Vol.128, pp.101-106
08/01/2020
DOI: 10.1016/j.amjcard.2020.04.034
PMID: 32650901
Abstract
The Marfan syndrome (MFS) patients are highly predisposed to thoracic aortic aneurysm and/or dissection, with virtually every patient having evidence of aortic disease at some point during their lifetime. We conducted a meta-analysis to investigate the efficacy of angiotensin receptor blockers (ARBs) in slowing down the progression of aortic dilatation in MFS patients. PUBMED, EMBASE, and COCHRANE databases were searched for relevant articles published from inception to February 1, 2020. We included randomized clinical trials evaluating the effect of ARBs on aortic root size in patients with MFS with a follow-up period of at least 2.5 years. Seven studies were included with a total of 1,510 patients. Our analysis demonstrated a significantly smaller change in aortic root and ascending aorta dilation in the ARBs treated group when compared with placebo (mean difference 0.68; 95% confidence interval [CI] -1.31 to -0.04; p = 0.04, I-2 = 94%, and mean difference -0.13, 95% CI -0.17 to -0.09; p < 0.00001, I-2 = 0%, respectively). ARBs as an add-on therapy to beta-blockers resulted in a significantly smaller change in aortic root dilation when compared with the arm without ARBs (mean difference -2.06, 95% CI -2.54 to -1.58; p < 0.00001, I-2 = 91%). However, there was no statistically significant difference in the number of clinical events (aortic complications/surgery) observed in the ARBs arm when compared with placebo (Risk ratio of 1.01, 95% CI 0.74 to 1.38; p = 0.94, I-2 = 0%). In conclusion, ARBs therapy is associated with a slower progression of aortic root dilation when compared with placebo and as an addition to beta-blocker therapy. (C) 2020 Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Meta-analysis Examining the Usefulness of Angiotensin Receptor blockers for the Prevention of Aortic Root Dilation in Patients With the Marfan Syndrome
- Creators
- Abdullah Al-abcha - Michigan State UniversityYehia Saleh - Michigan State UniversityMark Mujer - Michigan State UniversityManel Boumegouas - Michigan State UniversityKhader Herzallah - Michigan State UniversityLawrenshey Charles - Michigan State UniversityLayan Elkhatib - Henry Ford Hosp, Dept Internal Med, Detroit, MI 48202 USAOla Abdelkarim - Alexandria UniversityMichael Kehdi - Michigan State UniversityGeorge S. Abela - Michigan State University
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.128, pp.101-106
- Publisher
- Elsevier
- DOI
- 10.1016/j.amjcard.2020.04.034
- PMID
- 32650901
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Number of pages
- 6
- Language
- English
- Date published
- 08/01/2020
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984755390002771
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