Angiotensin Receptor Neprilysin Inhibition Compared With Enalapril on the Risk of Clinical Progression in Surviving Patients With Heart Failure
| Autor: | Packer, Milton, Mcmurray, John J. V., Desai, Akshay S., Gong, Jianjian, Lefkowitz, Martin P., Rizkala, Adel R., Rouleau, Jean L., Shi, Victor C., Solomon, Scott D., Swedberg, Karl, Zile, Michael, Andersen, Karl, Arango, Juan Luis, Arnold, J. Malcolm, Belohlávek, Jan, Böhm, Michael, Boytsov, Sergey, Burgess, Lesley J., Cabrera, Walter, Calvo, Carlos, Chen, Chen Huan, Dukat, Andrej, Duarte, Yan Carlos, Erglis, Andrejs, Michael, Fu, Gomez, Efrain, Gonzàlez Medina, Angel, Hagège, Albert A., Huang, Jun, Katova, Tzvetana, Kiatchoosakun, Songsak, Kim, Kee Sik, Kozan, Ömer, Llamas, Edmundo Bayram, Martinez, Felipe, Merkely, Bela, Mendoza, Iván, Mosterd, Arend, Negrusz Kawecka, Marta, Peuhkurinen, Keijo, Ramires, Felix J. A., Refsgaard, Jens, Rosenthal, Arvo, Senni, Michele, Sibulo, Antonio S., Silva Cardoso, José, Squire, Iain B., Starling, Randall C., Teerlink, John R., Vanhaecke, Johan, Vinereanu, Dragos, Wong, Raymond Ching Chiew, PARADIGM HF Investigators, Coordinators, Lembo, Giuseppe |
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| Přispěvatelé: | Neyses, Ludwig [collaborator], Packer, M, Mcmurray, J, Desai, A, Gong, J, Lefkowitz, M, Rizkala, A, Rouleau, J, Shi, V, Solomon, S, Swedberg, K, Zile, M, Andersen, K, Arango, J, Arnold, J, Belohlavek, J, Bohm, M, Boytsov, S, Burgess, L, Cabrera, W, Calvo, C, Chen, C, Dukat, A, Duarte, Y, Erglis, A, Fu, M, Gomez, E, Gonzalez-Medina, A, Hagege, A, Huang, J, Katova, T, Kiatchoosakun, S, Kim, K, Kozan, O, Llamas, E, Martinez, F, Merkely, B, Mendoza, I, Mosterd, A, Negrusz-Kawecka, M, Peuhkurinen, K, Ramires, F, Refsgaard, J, Rosenthal, A, Senni, M, Jr, A, Silva-Cardoso, J, Squire, I, Starling, R, Teerlink, J, Vanhaecke, J, Vinereanu, D, Wong, R |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Angiotensin receptor
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] receptors Tetrazoles heart failure Angiotensin-Converting Enzyme Inhibitors Kaplan-Meier Estimate Sacubitril Angiotensin Heart failure Neprilysin Receptors Aminobutyrates Angiotensin Receptor Antagonists Biomarkers Double-Blind Method Enalapril Heart Failure Humans Natriuretic Peptide Brain Peptide Fragments Risk Factors Stroke Volume Survivors Treatment Outcome Troponin Disease Progression Medicine (all) Cardiology and Cardiovascular Medicine Physiology (medical) Enalapril/therapeutic use Heart Failure/blood Receptor Systèmes cardiovasculaire & respiratoire [D03] [Sciences de la santé humaine] Troponin/blood Angiotensin Receptor Antagonists/therapeutic use Drug Combinations Angiotensin-Converting Enzyme Inhibitors/therapeutic use Tetrazoles/therapeutic use Cardiology Valsartan Heart Failure/blood/drug therapy/physiopathology medicine.drug medicine.medical_specialty neprilysin receptors angiotensin Internal medicine Renin–angiotensin system medicine heart failure neprilysin receptors angiotensin business.industry Biphenyl Compounds medicine.disease Endocrinology Aminobutyrates/therapeutic use Stroke Volume/physiology Natriuretic Peptide Brain/blood Cardiovascular & respiratory systems [D03] [Human health sciences] business Neprilysin/antagonists & inhibitors Peptide Fragments/blood Sacubitril Valsartan Biomarkers/blood |
| Zdroj: | Circulation, 131, 54-61 CIRCULATION r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA instname Circulation, 131(1), 54-61. United States (2015). PARADIGM-HF Investigators and Coordinators 2015, ' Angiotensin receptor neprilysin inhibition compared with enalapril on the risk of clinical progression in surviving patients with heart failure ', Circulation, vol. 131, no. 1, pp. 54-61 . https://doi.org/10.1161/CIRCULATIONAHA.114.013748 Circulation, 131, 1, pp. 54-61 |
| ISSN: | 0009-7322 |
| Popis: | Background— Clinical trials in heart failure have focused on the improvement in symptoms or decreases in the risk of death and other cardiovascular events. Little is known about the effect of drugs on the risk of clinical deterioration in surviving patients. Methods and Results— We compared the angiotensin-neprilysin inhibitor LCZ696 (400 mg daily) with the angiotensin-converting enzyme inhibitor enalapril (20 mg daily) in 8399 patients with heart failure and reduced ejection fraction in a double-blind trial. The analyses focused on prespecified measures of nonfatal clinical deterioration. In comparison with the enalapril group, fewer LCZ696-treated patients required intensification of medical treatment for heart failure (520 versus 604; hazard ratio, 0.84; 95% confidence interval, 0.74–0.94; P =0.003) or an emergency department visit for worsening heart failure (hazard ratio, 0.66; 95% confidence interval, 0.52–0.85; P =0.001). The patients in the LCZ696 group had 23% fewer hospitalizations for worsening heart failure (851 versus 1079; P P =0.005), to receive intravenous positive inotropic agents (31% risk reduction, P P =0.07). The reduction in heart failure hospitalization with LCZ696 was evident within the first 30 days after randomization. Worsening of symptom scores in surviving patients was consistently more common in the enalapril group. LCZ696 led to an early and sustained reduction in biomarkers of myocardial wall stress and injury (N-terminal pro–B-type natriuretic peptide and troponin) versus enalapril. Conclusions— Angiotensin-neprilysin inhibition prevents the clinical progression of surviving patients with heart failure more effectively than angiotensin-converting enzyme inhibition. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01035255. |
| Databáze: | OpenAIRE |
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