Heart failure & cardiomyopathiesRandomised controlled trial
In-hospital initiation of angiotensin receptor–neprilysin inhibition in acute heart failure: the PREMIER trial
- Randomised controlled trial
- investigator-initiated
- multicentre
- prospective
- open-label
- blinded-endpoint
- pragmatic
Authors' conclusion
In-hospital Sac/Val therapy initiation in addition to contemporary recommended therapy triggered a greater NT-proBNP level reduction in Japanese patients hospitalized for AHF.
Study context
- Population
- Japanese inpatients after an acute HF episode, haemodynamically stabilised within 7 days after hospitalisation376 analysed
- Participants
- 400 inpatients
- Comparison
- Sac/Val vs Control
- Primary endpoint
- Proportional change in geometric means of NT-proBNP levels
- Follow-up
- 8 weeks
Primary result
Per cent change in NT-proBNP geometric mean · Week 8
Group ratio
0.81
95% CI 0.68–0.95
P = 0.012
By group
Sac/Val
−45%
per cent change in geometric mean
Control
−32%
per cent change in geometric mean
As reported in the abstract
Further findings
| Outcome | Sac/Val | Control | group ratio (95% CI) | P value |
|---|---|---|---|---|
| Per cent change in NT-proBNP geometric mean · Week 4 | per cent change in geometric mean −35% | per cent change in geometric mean −18% | 0.80 (0.68–0.94) | P = 0.008 |
NT-proBNP change by subgroup (pre-specified)
- Effects of Sac/Val confined to LVEF < 40%; more evident in sinus rhythm and with MRA
Original publication
In-hospital initiation of angiotensin receptor–neprilysin inhibition in acute heart failure: the PREMIER trial. Eur Heart J. Published 31 August 2024. doi:10.1093/eurheartj/ehae561
Summarised from the published abstract; every number is checked against it