Heart failure & cardiomyopathies

2-Year Outcomes of an Atrial Shunt Device in HFpEF/HFmrEF: Results From REDUCE LAP-HF II

JACC Heart FailPublished Secondary analysis of the REDUCE LAP-HF II randomised trial

Primary resultResult — go to the resultWin ratio 1.01 95% CI 0.82–1.24

Authors' conclusion

At 2 years of follow-up in REDUCE LAP-HF II, there was no difference in efficacy between the atrial shunt and sham groups in the overall trial group.

Study context

Population
Patients with heart failure with preserved or mildly reduced EF
Participants
621 patients
Comparison
Atrial shunt vs sham procedure
  • Shuntn = 309
  • Shamn = 312reference
Primary endpoint
Hierarchical composite of:
  • CV death or nonfatal ischemic/embolic stroke
  • Total HF events
  • Change in health status
Follow-up
2 years
Methodological detailssham-controlled
  • Sham-controlled

Primary result

As reported in the abstract

Win ratio

1.01

95% CI 0.82–1.24

Shunt vs Sham
win ratio 1.01 (95% CI 0.82–1.24)

Further findings

OutcomeWin ratio (95% CI)P value
Primary endpoint in responders (subgroup, n = 313)1.36 (1.02–1.83)P = 0.037
Primary endpoint in nonresponders (subgroup, n = 265)0.73 (0.54–0.98)
OutcomeIRR (95% CI)P value
HF events in responders (subgroup) · 51% fewer HF events0.49 (0.25–0.95)P = 0.034
Shunt patency at 24 months
98%

Safety

MACE

P = 0.018

RV volume increase ≥30%

P < 0.001

MACE

CV mortality and nonfatal ischemic stroke not different between groups

RV volume increase ≥30%

RV dysfunction uncommon and not different between groups

Original publication

2-Year Outcomes of an Atrial Shunt Device in HFpEF/HFmrEF: Results From REDUCE LAP-HF II. JACC Heart Fail. Published 26 June 2024. doi:10.1016/j.jchf.2024.04.011

Summarised from the published abstract; every number is checked against it

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