Heart failure & cardiomyopathiesMeta-analysis
Effects of Sacubitril/Valsartan According to Natriuretic Peptide Levels in Patients Enrolled in PARADIGM-HF and PARAGON-HF
- Pooled individual patient data analysis of the PARADIGM-HF and PARAGON-HF randomised trials
- subgroup analysis by NT-proBNP quintile
Authors' conclusion
The relative risk reductions with sacubitril/valsartan were consistent irrespective of NT-proBNP level in HF patients across the range of LVEF. Consequently, the absolute risk reductions were greatest in patients with higher NT-proBNP levels.
Study context
- Population
- Heart failure (HF) patients with reduced, mildly reduced or preserved left ventricular ejection fraction (LVEF) enrolled in PARADIGM-HF and PARAGON-HF13,142 with baseline NT-proBNP
- Participants
- 13,195 patients
- Comparison
- Sacubitril/valsartan vs comparator, by NT-proBNP quintile
- Outcome
- HF hospitalization or CV death
- Follow-up
- Median 31 months
Pooled result
As reported in the abstract
HF hospitalization or CV death, sacubitril/valsartan effect by NT-proBNP quintile
Each group vs quintile 1Hazard ratio (95% CI)
Quintile 1
0.79(0.65–0.96)
Quintile 2
0.87(0.72–1.04)
Quintile 3
0.79(0.66–0.93)
Quintile 4
0.85(0.73–0.99)
Quintile 5
0.86(0.76–0.97)
Original publication
Effects of Sacubitril/Valsartan According to Natriuretic Peptide Levels in Patients Enrolled in PARADIGM-HF and PARAGON-HF. JACC Heart Fail. Published 12 March 2025. doi:10.1016/j.jchf.2024.12.010
Summarised from the published abstract; every number is checked against it