Sacubitril/Valsartan versus enalapril in nonischemic heart failure in Paradigm-Hf trial
Article Sidebar
Main Article Content
Abstract
Background: We compared the angiotensin receptor–neprilysin inhibitor LCZ696 (sacubitril/valsartan) with enalapril in patients who had nonischemic heart failure with a reduced ejection fraction.
Methods: In this double-blind trial, we randomly assigned 8442 patients with class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either LCZ696 (at a dose of 200 mg twice daily) or enalapril (at a dose of 10 mg twice daily), in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure, but the trial was designed to detect a difference in the rates of death from cardiovascular causes.
Results: The trial was stopped early, according to prespecified rules, after a median follow up of 27 months, because the boundary for an overwhelming benefit with LCZ696 had been crossed. The ischemic patients were 5036 (60%) patients and non-ischemic patients were 3363 (40%) patients. In ischemic and in non-ischemic group the LCZ696 was superior to enalapril for reduce primary outcome and CV death (P< 0.001). In LCZ696 group: the primary outcome had occurred in 339 patients (20.16 %) in the non-ischemic group and 575 patients (22.9 %) in the ischemic group (P: 0.03). A total of 199 patients (11.8%) in non-ischemic group and 359 patients in ischemic group (14.3%) died from cardiovascular causes (P: 0.01). and no significant difference between in CV death and primary outcome in enalapril group in the ischemic and non-ischemic patients.
Conclusions: LCZ696 was superior to enalapril in reducing the risks of cardiovascular death and hospitalization for heart failure in ischemic and non-ischemic heart failure.
Downloads
Article Details
Copyright (c) 2018 Habib M.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing and protecting the author rights is the central aim and core of the publishing business. Peertechz dedicates itself in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. Peertechz licensing terms are formulated to facilitate reuse of the manuscripts published in journals to take maximum advantage of Open Access publication and for the purpose of disseminating knowledge.
We support 'libre' open access, which defines Open Access in true terms as free of charge online access along with usage rights. The usage rights are granted through the use of specific Creative Commons license.
Peertechz accomplice with- [CC BY 4.0]
Explanation
'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.
With this license, the authors are allowed that after publishing with Peertechz, they can share their research by posting a free draft copy of their article to any repository or website.
'CC BY' license observance:
|
License Name |
Permission to read and download |
Permission to display in a repository |
Permission to translate |
Commercial uses of manuscript |
|
CC BY 4.0 |
Yes |
Yes |
Yes |
Yes |
The authors please note that Creative Commons license is focused on making creative works available for discovery and reuse. Creative Commons licenses provide an alternative to standard copyrights, allowing authors to specify ways that their works can be used without having to grant permission for each individual request. Others who want to reserve all of their rights under copyright law should not use CC licenses.
John JV, McMurray JJ, Packer M, Desai AS, Gong J, et al. (2014) Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure. N Engl J Med 371: 993-1004. https://goo.gl/YgiHsg
Simpson J, Jhund P, Rouleau J, Swedberg K, Zile M, et al. (2017) Effect os sacubtril/valsrtan compared with enalapril according to etiology in PARADIGM-HF. JACC 69. https://goo.gl/zcTt6f