Effect of valsartan on hospitalization: Results from Val-HeFT

Peter Carson, Gianni Tognoni, Jay N Cohn

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: Although current therapies have improved heart failure (HF) outcome, hospitalizations continue at high rates. The Valsartan Heart Failure Trial (Val-HeFT) showed that valsartan reduced the risk of first worsening HF hospitalization by 27.5% versus placebo (P < .001). This article analyzes all-cause and investigator-assessed HF hospitalization in Val-HeFT overall and in subgroups defined by preexisting HF therapy. Methods: Val-HeFT was a randomized, double-blind parallel-arm study in which HF patients (New York Heart Association class II-IV) received either valsartan (n = 2511, force-titrated to 160 mg twice daily) or placebo (n = 2499) in addition to prescribed HF therapy. Total and per patient-year investigator-assessed hospitalizations (all-cause or HF) were analyzed according to prescribed therapy at baseline (angiotensin-converting enzyme inhibitors [ACEI] and β-blockers [BB]). Results: Hospitalization for worsening HF accounted for 35% of all hospitalizations. There were 2856 and 3106 total all-cause hospitalizations in the valsartan and placebo groups, respectively, an 8% reduction (P = .145). Valsartan significantly reduced the overall number of investigator-assessed HF hospitalizations (-22.4%, P = .002) and reduced HF hospitalizations in the combination therapy subgroups (significant for ACEI+/BB- P = .003 and ACEI-/BB- P = .028) except those receiving both ACEI and BB. The benefit of valsartan versus placebo was more pronounced in reducing the number of patients with recurrent HF hospitalization (-20.6%) than single hospitalizations (-8.7%). Conclusions: Addition of valsartan to prescribed HF therapy demonstrated significant reductions in HF hospitalizations and was particularly beneficial in reducing recurrent HF hospitalization.

Original languageEnglish (US)
Pages (from-to)164-171
Number of pages8
JournalJournal of cardiac failure
Volume9
Issue number3
DOIs
StatePublished - Jan 1 2003

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Valsartan
Hospitalization
Heart Failure
Angiotensin-Converting Enzyme Inhibitors
Placebos
Research Personnel

Keywords

  • Angiotensin-converting enzyme inhibitors
  • Heart failure
  • Renin angiotensin system
  • β-blockers

Cite this

Effect of valsartan on hospitalization : Results from Val-HeFT. / Carson, Peter; Tognoni, Gianni; Cohn, Jay N.

In: Journal of cardiac failure, Vol. 9, No. 3, 01.01.2003, p. 164-171.

Research output: Contribution to journalArticle

Carson, Peter ; Tognoni, Gianni ; Cohn, Jay N. / Effect of valsartan on hospitalization : Results from Val-HeFT. In: Journal of cardiac failure. 2003 ; Vol. 9, No. 3. pp. 164-171.
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abstract = "Background: Although current therapies have improved heart failure (HF) outcome, hospitalizations continue at high rates. The Valsartan Heart Failure Trial (Val-HeFT) showed that valsartan reduced the risk of first worsening HF hospitalization by 27.5{\%} versus placebo (P < .001). This article analyzes all-cause and investigator-assessed HF hospitalization in Val-HeFT overall and in subgroups defined by preexisting HF therapy. Methods: Val-HeFT was a randomized, double-blind parallel-arm study in which HF patients (New York Heart Association class II-IV) received either valsartan (n = 2511, force-titrated to 160 mg twice daily) or placebo (n = 2499) in addition to prescribed HF therapy. Total and per patient-year investigator-assessed hospitalizations (all-cause or HF) were analyzed according to prescribed therapy at baseline (angiotensin-converting enzyme inhibitors [ACEI] and β-blockers [BB]). Results: Hospitalization for worsening HF accounted for 35{\%} of all hospitalizations. There were 2856 and 3106 total all-cause hospitalizations in the valsartan and placebo groups, respectively, an 8{\%} reduction (P = .145). Valsartan significantly reduced the overall number of investigator-assessed HF hospitalizations (-22.4{\%}, P = .002) and reduced HF hospitalizations in the combination therapy subgroups (significant for ACEI+/BB- P = .003 and ACEI-/BB- P = .028) except those receiving both ACEI and BB. The benefit of valsartan versus placebo was more pronounced in reducing the number of patients with recurrent HF hospitalization (-20.6{\%}) than single hospitalizations (-8.7{\%}). Conclusions: Addition of valsartan to prescribed HF therapy demonstrated significant reductions in HF hospitalizations and was particularly beneficial in reducing recurrent HF hospitalization.",
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AB - Background: Although current therapies have improved heart failure (HF) outcome, hospitalizations continue at high rates. The Valsartan Heart Failure Trial (Val-HeFT) showed that valsartan reduced the risk of first worsening HF hospitalization by 27.5% versus placebo (P < .001). This article analyzes all-cause and investigator-assessed HF hospitalization in Val-HeFT overall and in subgroups defined by preexisting HF therapy. Methods: Val-HeFT was a randomized, double-blind parallel-arm study in which HF patients (New York Heart Association class II-IV) received either valsartan (n = 2511, force-titrated to 160 mg twice daily) or placebo (n = 2499) in addition to prescribed HF therapy. Total and per patient-year investigator-assessed hospitalizations (all-cause or HF) were analyzed according to prescribed therapy at baseline (angiotensin-converting enzyme inhibitors [ACEI] and β-blockers [BB]). Results: Hospitalization for worsening HF accounted for 35% of all hospitalizations. There were 2856 and 3106 total all-cause hospitalizations in the valsartan and placebo groups, respectively, an 8% reduction (P = .145). Valsartan significantly reduced the overall number of investigator-assessed HF hospitalizations (-22.4%, P = .002) and reduced HF hospitalizations in the combination therapy subgroups (significant for ACEI+/BB- P = .003 and ACEI-/BB- P = .028) except those receiving both ACEI and BB. The benefit of valsartan versus placebo was more pronounced in reducing the number of patients with recurrent HF hospitalization (-20.6%) than single hospitalizations (-8.7%). Conclusions: Addition of valsartan to prescribed HF therapy demonstrated significant reductions in HF hospitalizations and was particularly beneficial in reducing recurrent HF hospitalization.

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