Heart failure & cardiomyopathies

Angiotensin Receptor Neprilysin Inhibition and Cardiovascular Outcomes Across the Kidney Function Spectrum: The PARAGON-HF Trial

JACC Heart FailPublished Secondary analysis of the PARAGON-HF randomised trial

Primary resultResult — go to the resultRelative risk 0.69 95% CI 0.51–0.94

Authors' conclusion

In the PARAGON-HF trial, the benefits of sacubitril/valsartan to reduce the frequency of HF hospitalizations and cardiovascular death were most apparent in patients with lower baseline eGFR and lower ejection fraction.

Study context

Population
Chronic heart failure (HF) with left ventricular ejection fraction (LVEF) ≥45%, by baseline kidney function1,955 (41%) with estimated glomerular filtration rate (eGFR) <60
Participants
4,796 participants
Comparison
Sacubitril/valsartan vs valsartan
Primary endpoint
CV death and total HF hospitalizations, by baseline eGFR
Methodological detailssubgroup analysis by baseline eGFR and LVEF
  • Subgroup analysis by baseline eGFR and LVEF

Primary result

As reported in the abstract

Relative risk

0.69

95% CI 0.51–0.94

Sacubitril/valsartanvs Valsartan
RR 0.69 (95% CI 0.51–0.94)
Greater reduction with lower baseline eGFR (P interaction, continuous eGFR)
0.07

Further findings

CV death, by baseline eGFR (subgroup)

Nonlinear influence of eGFR on treatment effect; most pronounced with baseline eGFR <45 mL/min/1.73 m²
HR: 0.65; 95% CI: 0.43-0.97

Primary outcome, by LVEF and eGFR (subgroup)

Treatment effect most pronounced with LVEF ≤57% and eGFR ≤45 mL/min/1.73 m²
HR: 0.66; 95% CI: 0.45-0.97

Original publication

Angiotensin Receptor Neprilysin Inhibition and Cardiovascular Outcomes Across the Kidney Function Spectrum: The PARAGON-HF Trial. JACC Heart Fail. Published 20 November 2024. doi:10.1016/j.jchf.2024.08.022

Composed by AI from the published abstract and checked against it. How Briefs are made →

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