The analysis of PRA levels in a randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure (Val-HeFT
) included 4300 patients and revealed a modest correlation of renin with other neurohormones such as BNP, norepinephrine, or aldosterone (24).
With similar results and design, the Valsartan Heart Failure Trial (Val-HeFT
) trial eligibility required a history of NYHA class II to IV along with a regimen to include ACE inhibitors, diuretics, digoxin, and a-blockers (Cohn, 2001).
Direct comparison of B-Type natriuretic peptide (BNP) and amino-terminal proBNP in a large population of patients with chronic and symptomatic heart failure: the Valsartan Heart Failure (Val-HeFT
The Valsartan Heart Failure Trial (Val-HeFT
) and the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) trial showed some improvement in the efficacy of ARBs when used with ACE inhibitors.
In the Valsartan Heart Failure Trial (Val-HeFT
), triple therapy with Diovan, an ACE inhibitor, and a [beta]-blocker was associated with greater mortality and morbidity.
In a biomarker substudy from the Valsartan Heart Failure Trial (Val-HeFT
) in 1734 patients with HFrEF, GDF-15 concentrations increased by approximately 8% during the course of 12 months, with similar increases in patients randomized to placebo or valsartan (60).
Particularly noteworthy was a retrospective analysis of data from the land-mark Studies of Left Ventricular Dysfunction (SOLVD) and second Valsartan Heart Failure Trial (Val-HeFT
Particularly noteworthy was a retrospective analysis of data from the landmark Studies of Left Ventricular Dysfunction (SOLVD) and second Valsartan Heart Failure Trial (Val-HeFT
A post hoc analysis of the Valsartan Heart Failure Trial (Val-HeFT
) even pointed in the opposite direction, showing a predominant effect of valsartan on reducing HF hospitalizations in patients with low galectin-3, but not in those with higher plasma concentrations of galectin-3 (20).
The benefit was equally robust in patients who also were on a [beta]-blocker, contrary to the results of the earlier Valsartan Heart Failure Trial (Val-HeFT
Aldo Maggioni reported on new findings from the Valsartan Heart Failure Trial (Val-HeFT
), a randomized double-blind study in which 5,010 patients with congestive heart failure (CHF) received valsartan or placebo in addition to the standard medications for CHF.
For example, using research versions of the hs-cTnT assay, investigators from the Valsartan Heart Failure Trial (Val-HeFT
) and Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE) trials demonstrated cTnT to be detectable at very low concentrations in nearly 100% of patients with stable chronic heart failure or chronic coronary artery disease; moreover, increasing concentrations of cTnT still well below the detection limit of standard cTnT assays were associated with progressively higher rates of death and heart failure progression or development (1, 2).