The Impact of Dose of Angiotensin-receptor Blocker Valsartan and Genetic Polymorphism on the Post-MI Ventricular Remodeling (VALID)
Angiotensin-converting enzyme inhibitors and angiotensin-receptor blocker valsartan ameliorate ventricular remodeling after myocardial infarction (MI). Although the amount of those drugs used in previous clinical trials, therefore recommended in practical guidelines is maximum clinical dose, it has not been clearly demonstrated whether the recommended dose is more efficacious compared to lower dose commonly used in clinical practice. In addition, the impact of genetic polymorphism in neurohormonal system on the pharmacological effect has not been explored in the setting of post-MI remodeling.
Therefore, the investigators evaluate whether submaximal dose, which are lower than those in major pivotal trials but typically used in clinical practice, can offer similar benefit in post-MI ventricular remodeling.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Busan, Korea, Republic of
- Department of Internal Medicine,Dong-A University College of Medicine
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Both gender
- Age > 18
- First episode of acute ST-elevation MI
- An echocardiographic left ventricular ejection fraction less than 50 %
- Patients who provide written informed consent
Exclusion Criteria:
- Contraindications for use of angiotensin receptor blockers (ARBs)(hypersensitivity, pregnancy, bilateral renal artery stenosis)
- Urgent need for revascularization procedure
- Severe heart failure (need for intravenous inotropic support)
- Persistent (> 1 hour) severe hypotension (systolic blood pressure < 90 mmHg)
- Refractory or potentially lethal arrhythmias
- Hemodynamically significant right ventricular infarction
- Primary valvular diseases
- Congenital heart disease
- Idiopathic hypertrophic cardiomyopathy
- Concomitant inflammatory cardiopathy
- Significant hepatic dysfunction
- Significant renal dysfunction
- Anemia (hemoglobin < 10 mg/mL)
- Psychiatric disorders, alcohol or durg abuse
- Any concomitant disease that might interfere with drug evaluation (especially if life expectancy is less than 1 year)
- Participation in any other pharmacological study within 2 months
- Refusal or inability to provide informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Valsartan,high dose
high dose group (valsartan up to 320 mg/day)
|
comparison of different dosages of drug
|
|
Other: Valsartan, usual dose
usual dose group (valsartan 80 mg/day)
|
comparison of different dosages of drug
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in the left ventricular volume index from baseline to follow-up
Time Frame: at 24hrs, 1month, and 12months after myocardial infarction
|
We measured a left ventriular volume index by echocardiography.
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at 24hrs, 1month, and 12months after myocardial infarction
|
|
left ventricular volume index
Time Frame: at 12months after myocardial infarction
|
at 12months after myocardial infarction
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
clinical events
Time Frame: during 12 months follow up
|
Clinical events were defined as all cause death and hospitalization due to cardiovascular problems.
|
during 12 months follow up
|
|
clinical events
Time Frame: at 12 months after myocardial infarction
|
at 12 months after myocardial infarction
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Ischemia
- Pathologic Processes
- Necrosis
- Myocardial Ischemia
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Pathological Conditions, Anatomical
- Myocardial Infarction
- Infarction
- Ventricular Remodeling
- Molecular Mechanisms of Pharmacological Action
- Antihypertensive Agents
- Angiotensin II Type 1 Receptor Blockers
- Angiotensin Receptor Antagonists
- Valsartan
Other Study ID Numbers
Other Study ID Numbers
- Donga 419
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