Metanalysis Examining the Usefulness of Angiotensin Receptor Blockers for the Prevention of Aortic Root Dilation in Patients with the Marfan Syndrome

Abstract The Marfan syndrome (MFS) patients are highly predisposed to thoracic aortic aneurysm and/or dissection, with virtually every patient having evidence of aortic disease at some point during their lifetime. We conducted a meta-analysis to investigate the efficacy of angiotensin receptor blockers (ARBs) in slowing down the progression of aortic dilatation in MFS patients. PUBMED, EMBASE, and COCHRANE databases were searched for relevant articles published from inception to February 1, 2020. We included randomized clinical trials evaluating the effect of ARBs on aortic root size in patients with MFS with a follow-up period of at least 2.5 years. Seven studies were included with a total of 1,510 patients. Our analysis demonstrated a significantly smaller change in aortic root and ascending aorta dilation in the ARBs treated group when compared to placebo (mean difference 0.68; 95% confidence interval (CI) (-1.31 to -0.04; p=0.04, I2=94%, and mean difference -0.13, 95% CI -0.17 to -0.09; p