Back to Search
Start Over
The Beneficial Effect of Renin-Angiotensin-Aldosterone System Blockade in Marfan Syndrome Patients after Aortic Root Replacement.
- Source :
-
Yonsei medical journal [Yonsei Med J] 2016 Jan; Vol. 57 (1), pp. 81-7. - Publication Year :
- 2016
-
Abstract
- Purpose: In this study, we evaluated the long term beneficial effect of Renin-Angiotensin-Aldosterone System (RAAS) blockade therapy in treatment of Marfan aortopathy.<br />Materials and Methods: We reviewed Marfan syndrome (MFS) patients who underwent aortic root replacement (ARR) between January 1996 and January 2011. All patients were prescribed β-blockers indefinitely. We compared major aortic events including mortality, aortic dissection, and reoperation in patients without RAAS blockade (group 1, n=27) to those with (group 2, n=63). The aortic growth rate was calculated by dividing the diameter change on CT scans taken immediately post-operatively and the latest scan available.<br />Results: There were no differences in clinical parameters except for age which was higher in patients with RAAS blockade. In group 1, 2 (7%) deaths, 5 (19%) aortic dissections, and 7 (26%) reoperations occurred. In group 2, 3 (5%) deaths, 2 (3%) aortic dissections, and 3 (5%) reoperations occurred. A Kaplan-Meier plot demonstrated improved survival free from major aortic events in group 2. On multivariate Cox, RAAS blockade was an independent negative predictor of major aortic events (hazard ratio 0.38, 95% confidence interval 0.30-0.43, p=0.002). Mean diameter change in descending thoracic and supra-renal abdominal aorta was significantly higher in patients without RAAS blockade (p<0.05).<br />Conclusion: In MFS patients who underwent ARR, the addition of RAAS blockade to β-blocker was associated with reduction of aortic dilatation and clinical events.
- Subjects :
- Adrenergic beta-Antagonists pharmacology
Aged
Aortic Dissection complications
Aortic Dissection mortality
Aortic Dissection surgery
Aorta pathology
Aortic Aneurysm complications
Aortic Aneurysm mortality
Aortic Aneurysm surgery
Aortic Valve
Female
Humans
Male
Marfan Syndrome mortality
Middle Aged
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors therapeutic use
Aorta surgery
Marfan Syndrome surgery
Renin-Angiotensin System drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1976-2437
- Volume :
- 57
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Yonsei medical journal
- Publication Type :
- Academic Journal
- Accession number :
- 26632386
- Full Text :
- https://doi.org/10.3349/ymj.2016.57.1.81