Use of the angiotensin receptor blocker irbesartan in children and young adults with Marfan syndrome slowed aortic dilatation, potentially delaying the need for surgery, said researchers presenting findings from the AIMS Trial on Aug. 28 at ESC Congress 2018.

Researchers randomized 192 patients aged six to 40 years from 22 centers in the UK to either irbesartan once daily (150–300 mg depending on body weight) or placebo. In both treatment groups the median age of participants was 18 years. More than 56 percent of study participants took beta-blockers. Aortic diameter was assessed using transthoracic echocardiography at baseline and at yearly intervals for up to 5 years.

While aortas in both groups continued to enlarge, researchers noted the rate of dilatation was slower in the irbesartan group compared with the placebo group (0.53 mm vs. 0.74 mm per year, respectively) – a statistically significant reduction of 0.22 mm per year. The rate of adverse events, including the need for cardiac surgery to replace the aortic root was similar across the two groups.

"The trial showed a clinically important reduction in the rate of aortic dilatation in children and young adults with Marfan syndrome treated with irbesartan, potentially delaying the need for elective surgery and reducing the risk of complications and death," said Michael Mullen, MD, of St Bartholomew's Hospital, London, UK.

Keywords: ESC18, ESC Congress, Biphenyl Compounds, Tetrazoles, Aorta

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