Myocardial Infarction Clinical Trial
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.
A total of 1116 patients with left ventricular (LV) dysfunction following the first episode of acute ST-elevation MI are to be enrolled and randomized to maximal tolerable dose (up to 320 mg/day) or usual dose (80 mg/day) of valsartan for 12 months in 2:1 ratio. Echocardiographic analysis for quantifying post-MI ventricular remodeling and genotyping of blood samples are conducted in central core laboratory. Clinical assessment and laboratory test are performed at fixed times, and genetic polymorphisms of the patients are tested at the time of admission. ;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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