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dc.contributor.authorTeixido-Tura, Gisela
dc.contributor.authorForteza, Alberto
dc.contributor.authorRodríguez-Palomares, Jose
dc.contributor.authorGonzalez-Mirelis, Jesus 
dc.contributor.authorGutiérrez, Laura
dc.contributor.authorSánchez, Violeta
dc.contributor.authorIbanez, Borja 
dc.contributor.authorGarcia-Dorado, David
dc.contributor.authorEvangelista, Artur
dc.identifier.citationJ Am Coll Cardiol. 2018; 72(14):1613-1618es_ES
dc.description.abstractBACKGROUND: Beta-blockers are the standard treatment in Marfan syndrome (MFS). Recent clinical trials with limited follow-up yielded conflicting results on losartan's effectiveness in MFS. OBJECTIVES: The present study aimed to evaluate the benefit of losartan compared with atenolol for the prevention of aortic dilation and complications in Marfan patients over a longer observation period (>5 years). METHODS: A total of 128 patients included in the previous LOAT (LOsartan vs ATenolol) clinical trial (64 in the atenolol and 64 in the losartan group) were followed up for an open-label extension of the study, with the initial treatment maintained. RESULTS: Mean clinical follow-up was 6.7 ± 1.5 years. A total of 9 events (14.1%) occurred in the losartan group and 12 (18.8%) in the atenolol group. Survival analysis showed no differences in the combined endpoint of need for aortic surgery, aortic dissection, or death (p = 0.462). Aortic root diameter increased with no differences between groups: 0.4 mm/year (95% confidence interval: 0.2 to 0.5) in the losartan and 0.4 mm/year (95% confidence interval: 0.3 to 0.6) in the atenolol group. In the subgroup analyses, no significant differences were observed considering age, baseline aortic root diameter, or type of dominant negative versus haploinsufficient FBN1 mutation. CONCLUSIONS: Long-term outcome of Marfan syndrome patients randomly assigned to losartan or atenolol showed no differences in aortic dilation rate or presence of clinical events between treatment groups. Therefore, losartan might be a useful, low-risk alternative to beta-blockers in the long-term management of these patients.es_ES
dc.description.sponsorshipThis work was been funded by a grant of the Spanish Society of Cardiology and CIBERCV. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.es_ES
dc.subjectMarfan syndromees_ES
dc.subjectaortic aneurysmes_ES
dc.subject.meshAdrenergic beta-1 Receptor Antagonists es_ES
dc.subject.meshAdult es_ES
dc.subject.meshAneurysm, Dissecting es_ES
dc.subject.meshAngiotensin II Type 1 Receptor Blockers es_ES
dc.subject.meshAorta es_ES
dc.subject.meshAortic Aneurysm es_ES
dc.subject.meshAtenolol es_ES
dc.subject.meshDilatation, Pathologic es_ES
dc.subject.meshDisease Progression es_ES
dc.subject.meshFemale es_ES
dc.subject.meshFollow-Up Studies es_ES
dc.subject.meshHumans es_ES
dc.subject.meshLosartan es_ES
dc.subject.meshMagnetic Resonance Imaging, Cine es_ES
dc.subject.meshMale es_ES
dc.subject.meshMarfan Syndrome es_ES
dc.subject.meshYoung Adult es_ES
dc.titleLosartan Versus Atenolol for Prevention of Aortic Dilation in Patients With Marfan Syndromees_ES
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.contributor.funderSociedad Española de Cardiologíaes_ES
dc.contributor.funderCentro de Investigación Biomedica en Red - CIBERes_ES
dc.identifier.journalJournal of the American College of Cardiologyes_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Laboratorio Traslacional para la Imagen y Terapia Cardiovasculares_ES

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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
This item is licensed under a: Attribution-NonCommercial-NoDerivatives 4.0 Internacional