VALsartan In Acute myocardial iNfarcTion (VALIANT) trial: baseline characteristics in context.


Journal Article

BACKGROUND: The VALsartan In Acute myocardial iNfarcTion (VALIANT) trial compared outcomes with: (1) angiotensin-converting enzyme inhibition (ACEI) with the reference agent captopril; (2) angiotensin-receptor blockade (ARB) with valsartan; or (3) both in patients with heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) after myocardial infarction (MI). AIMS: a goal of this active-control trial was to simulate conditions that would lead current practitioners to use ACEIs. Thus, we compared characteristics of VALIANT patients with those of patients in placebo-controlled trials that established ACEIs as standard treatment. METHODS AND RESULTS: We collected demographic, clinical, medication and imaging information from 14703 patients in 24 countries. This high-risk population was a median 65.8 years old, and 31.1% were female. Most (51.8%) showed imaging evidence of LVSD at enrollment. Most (72%) had Killip class>/=II HF. Patients received evidence-based therapies at rates similar to those of contemporary MI trials and at an improved rate compared with prior placebo-controlled ACEI trials. CONCLUSION: VALIANT represents the largest globally representative cohort enrolled with HF and/or LVSD after MI. Patients were similar to those in placebo-controlled ACEI trials while reflecting improvements in evidence-based care. With enrollment complete, VALIANT is poised to define the optimal strategy for renin-angiotensin system blockade after MI to improve cardiovascular outcomes.

Full Text

Duke Authors

Cited Authors

  • Velazquez, EJ; Pfeffer, MA; McMurray, JV; Maggioni, AP; Rouleau, JL; Van de Werf, F; Kober, L; White, HD; Swedberg, K; Leimberger, JD; Gallo, P; Sellers, MA; Edwards, S; Henis, M; Califf, RM; VALIANT Investigators,

Published Date

  • August 2003

Published In

Volume / Issue

  • 5 / 4

Start / End Page

  • 537 - 544

PubMed ID

  • 12921816

Pubmed Central ID

  • 12921816

International Standard Serial Number (ISSN)

  • 1388-9842

Digital Object Identifier (DOI)

  • 10.1016/s1388-9842(03)00112-0


  • eng

Conference Location

  • England