Heart failure & cardiomyopathiesSecondary analysis
Effects of Sacubitril/Valsartan According to Polypharmacy Status in PARAGON-HF
- Post hoc analysis of the PARAGON-HF randomised trial
- subgroup analysis by polypharmacy status
Authors' conclusion
Polypharmacy is very common in patients with HFpEF, and those with polypharmacy have worse clinical status and a higher rate of non-fatal and fatal outcomes. The benefit of sacubitril/valsartan was not diminished in patients taking a larger number of medications at baseline.
Study context
- Population
- Patients with HFpEF in PARAGON-HF with baseline medication statusof 4796 in primary analysis
- Participants
- 4,793 patients
- Comparison
- Sacubitril/valsartan vs valsartan, by number of medications at baseline
- Non-polypharmacyn = 683
- Polypharmacyn = 2,750
- Hyper-polypharmacyn = 1,360
- Primary endpoint
- Total HF hospitalizations and CV deaths
Primary result
As reported in the abstract
Total HF hospitalizations and CV deaths, by polypharmacy category
Sacubitril/valsartan vs ValsartanRate ratio (CI)
Non-polypharmacy
1.19(0.76–1.85)
Polypharmacy
0.94(0.77–1.15)
Hyper-polypharmacy
0.77(0.61–0.96)
Further findings
Primary outcome risk by polypharmacy category (non-adjusted)
- Significantly higher non-adjusted risk with more medications; similar trends for heart failure (HF) hospitalization, CV and all-cause death
Safety
Treatment-related adverse events
- More common in higher polypharmacy categories but not more common with sacubitril/valsartan vs valsartan in any category
Original publication
Effects of Sacubitril/Valsartan According to Polypharmacy Status in PARAGON-HF. Eur J Heart Fail. Published 8 April 2024. doi:10.1002/ejhf.3223
Summarised from the published abstract; every number is checked against it