VALsartan In Acute myocardial iNfarcTion (VALIANT) trial: baseline characteristics in context

Eur J Heart Fail. 2003 Aug;5(4):537-44. doi: 10.1016/s1388-9842(03)00112-0.


Background: The VALsartan In Acute myocardial iNfarcTion (VALIANT) trial compared outcomes with: (1) angiotensin-converting enzyme inhibition (ACEI) with the reference agent captopril; (2) angiotensin-receptor blockade (ARB) with valsartan; or (3) both in patients with heart failure (HF) and/or left ventricular systolic dysfunction (LVSD) after myocardial infarction (MI).

Aims: a goal of this active-control trial was to simulate conditions that would lead current practitioners to use ACEIs. Thus, we compared characteristics of VALIANT patients with those of patients in placebo-controlled trials that established ACEIs as standard treatment.

Methods and results: We collected demographic, clinical, medication and imaging information from 14703 patients in 24 countries. This high-risk population was a median 65.8 years old, and 31.1% were female. Most (51.8%) showed imaging evidence of LVSD at enrollment. Most (72%) had Killip class>/=II HF. Patients received evidence-based therapies at rates similar to those of contemporary MI trials and at an improved rate compared with prior placebo-controlled ACEI trials.

Conclusion: VALIANT represents the largest globally representative cohort enrolled with HF and/or LVSD after MI. Patients were similar to those in placebo-controlled ACEI trials while reflecting improvements in evidence-based care. With enrollment complete, VALIANT is poised to define the optimal strategy for renin-angiotensin system blockade after MI to improve cardiovascular outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiotensin Receptor Antagonists*
  • Captopril / therapeutic use
  • Double-Blind Method
  • Female
  • Glyceraldehyde-3-Phosphate Dehydrogenases / therapeutic use
  • Heart Failure / drug therapy*
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Myocardial Infarction / drug therapy*
  • Peptide Fragments / therapeutic use
  • Randomized Controlled Trials as Topic
  • Tetrazoles / therapeutic use*
  • Valine / analogs & derivatives
  • Valine / therapeutic use*
  • Valsartan
  • Ventricular Dysfunction, Left / drug therapy


  • Angiotensin Receptor Antagonists
  • Peptide Fragments
  • Tetrazoles
  • glyceraldehyde 3-phosphate dehydrogenase (304-313)
  • Valsartan
  • Captopril
  • Glyceraldehyde-3-Phosphate Dehydrogenases
  • Valine