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The effects of sacubitril/valsartan on coronary outcomes in PARADIGM-HF.
- Source :
- American Heart Journal; Jun2017, Vol. 188, p35-41, 7p
- Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>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.<bold>Methods and Results: </bold>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.<bold>Conclusions: </bold>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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00028703
- Volume :
- 188
- Database :
- Supplemental Index
- Journal :
- American Heart Journal
- Publication Type :
- Academic Journal
- Accession number :
- 123370997
- Full Text :
- https://doi.org/10.1016/j.ahj.2017.02.034