TY - JOUR
T1 - The effects of sacubitril/valsartan on coronary outcomes in PARADIGM-HF
AU - Mogensen, Ulrik M.
AU - Køber, Lars
AU - Kristensen, Søren L.
AU - Jhund, Pardeep S.
AU - Gong, Jianjian
AU - Lefkowitz, Martin P.
AU - Rizkala, Adel R.
AU - Rouleau, Jean L.
AU - Shi, Victor C.
AU - Swedberg, Karl
AU - Zile, Michael R.
AU - Solomon, Scott D.
AU - Packer, Milton
AU - McMurray, John J V
N1 - Publisher Copyright:
© 2017
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Background Angiotensin converting enzyme inhibitors (ACE-I), are beneficial both in heart failure with reduced ejection fraction (HF-REF) and after myocardial infarction (MI). We examined the effects of the angiotensin-receptor neprilysin inhibitor sacubitril/valsartan, compared with the ACE-I enalapril, on coronary outcomes in PARADIGM-HF. Methods and results We examined the effect of sacubitril/valsartan compared with enalapril on the following outcomes: i) the primary composite endpoint of cardiovascular (CV) death or HF hospitalization, ii) a pre-defined broader composite including, in addition, MI, stroke, and resuscitated sudden death, and iii) a post hoc coronary composite of CV-death, non-fatal MI, angina hospitalization or coronary revascularization. At baseline, of 8399 patients, 3634 (43.3%) had a prior MI and 4796 (57.1%) had a history of any coronary artery disease. Among all patients, compared with enalapril, sacubitril/valsartan reduced the risk of the primary outcome (HR 0.80 [0.73–0.87], P < .001), the broader composite (HR 0.83 [0.76–0.90], P < .001) and the coronary composite (HR 0.83 [0.75–0.92], P < .001). Although each of the components of the coronary composite occurred less frequently in the sacubitril/valsartan group, compared with the enalapril group, only CV death was reduced significantly. Conclusions Compared with enalapril, sacubitril/valsartan reduced the risk of both the primary endpoint and a coronary composite outcome in PARADIGM-HF. Additional studies on the effect of sacubitril/valsartan on atherothrombotic outcomes in high-risk patients are merited.
AB - Background Angiotensin converting enzyme inhibitors (ACE-I), are beneficial both in heart failure with reduced ejection fraction (HF-REF) and after myocardial infarction (MI). We examined the effects of the angiotensin-receptor neprilysin inhibitor sacubitril/valsartan, compared with the ACE-I enalapril, on coronary outcomes in PARADIGM-HF. Methods and results We examined the effect of sacubitril/valsartan compared with enalapril on the following outcomes: i) the primary composite endpoint of cardiovascular (CV) death or HF hospitalization, ii) a pre-defined broader composite including, in addition, MI, stroke, and resuscitated sudden death, and iii) a post hoc coronary composite of CV-death, non-fatal MI, angina hospitalization or coronary revascularization. At baseline, of 8399 patients, 3634 (43.3%) had a prior MI and 4796 (57.1%) had a history of any coronary artery disease. Among all patients, compared with enalapril, sacubitril/valsartan reduced the risk of the primary outcome (HR 0.80 [0.73–0.87], P < .001), the broader composite (HR 0.83 [0.76–0.90], P < .001) and the coronary composite (HR 0.83 [0.75–0.92], P < .001). Although each of the components of the coronary composite occurred less frequently in the sacubitril/valsartan group, compared with the enalapril group, only CV death was reduced significantly. Conclusions Compared with enalapril, sacubitril/valsartan reduced the risk of both the primary endpoint and a coronary composite outcome in PARADIGM-HF. Additional studies on the effect of sacubitril/valsartan on atherothrombotic outcomes in high-risk patients are merited.
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U2 - 10.1016/j.ahj.2017.02.034
DO - 10.1016/j.ahj.2017.02.034
M3 - Article
C2 - 28577679
AN - SCOPUS:85016075621
SN - 0002-8703
VL - 188
SP - 35
EP - 41
JO - American heart journal
JF - American heart journal
ER -