title: The effect of losartan on progressive aortic dilatation in patients with Marfan's syndrome: a meta-analysis of prospective randomized clinical trials.
abstract: OBJECTIVE
  To assess the effect of losartan therapy on progressive aortic dilatation and on clinical outcome in patients with Marfan's syndrome (MFS).
  
  
  METHODS
  The meta-analysis was instituted, which included studies identified by a systematic review of MEDLINE of peer-reviewed publications. Echocardiogram or MRI measurements of the aortic root dimension and outcome measures of death, cardiovascular surgery and aortic dissection or rupture were compared between patients who were treated and untreated with losartan therapy.
  
  
  RESULTS
  Six randomized trials with 1398 subjects met all the inclusion criteria and were included in the meta-analysis. Compared with non-losartan treatment, losartan therapy significantly decreased the rate of aortic dilatation (SMD=-0.13 with 95% CI -0.25 to 0.00, p=0.04). The clinical outcome beneficial was not observed in the losartan treatment group when compared with no losartan treatment group (odds ratio=1.04 with 95% CI of 0.57-1.87).
  
  
  CONCLUSIONS
  Given the current results of the meta-analysis and together with the lack of associated side effects, it would be reasonable to use losartan in MFS patients with aortic root dilatation. However, no clinical outcome benefits were observed in the losartan treatment group when compared with no losartan treatment group.
authors.affiliation: Department of Comprehensive Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China. Electronic address: gaolinggen@163.com.
authors.forename: Linggen
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Thoracic Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Geriatric Cardiology, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
authors.forename: Li
authors.initials: L
authors.lastname: Fan
authors.affiliation: Department of Comprehensive Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
authors.forename: Dewei
authors.initials: D
authors.lastname: Gao
authors.affiliation: Department of Comprehensive Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
authors.forename: Zhiru
authors.initials: Z
authors.lastname: Liang
authors.affiliation: Department of Comprehensive Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China. Electronic address: wangrong6969@126.com.
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Comprehensive Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
authors.forename: Wenning
authors.initials: W
authors.lastname: Lu
mesh_terms: D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004108:Dilatation, Pathologic; D004452:Echocardiography; D005260:Female; D006801:Humans; D019808:Losartan / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008382:Marfan Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D019808:Losartan
keywords: Aortic root dilatation; Clinical outcome; Losartan therapy; Marfan's syndrome