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During the past two decades some authorities have recommended prophylactic beta-blockers to reduce the risk for aortic dissection in patients with Marfan's syndrome. A randomized trial now provides indirect evidence to support this practice.
The study involved 70 patients with Marfan's syndrome (mean age, 15 years); 32 received propranolol (mean daily dose, 212 mg) and 38 received no treatment. During 10 years of follow-up, the propranolol group had a significantly lower rate of increase in their aortic diameter than the control group. Two propranolol-treated patients had aortic dissection, versus four controls; two patients in each group had aortic regurgitation; and two patients in the control group died for reasons unrelated to the aorta.…