Heart failure & cardiomyopathies

Sacubitril/Valsartan Reduces Incident Anaemia and Iron Therapy Utilization in Heart Failure: The PARAGON-HF Trial

Eur J Heart FailPublished Secondary analysis of the PARAGON-HF randomised trial

Primary result · Incident anaemiaResult — go to the resultHazard ratio 0.76 95% CI 0.68–0.85

Authors' conclusion

Among patients with HFmrEF/HFpEF, treatment with sacubitril/valsartan resulted in modestly smaller declines in haemoglobin, lower rates of incident anaemia, and fewer new initiations of iron therapy compared with RASi.

Study context

Population
Patients with heart failure (HF) and LVEF ≥45% (HFmrEF/HFpEF)
Participants
4,795 patients
Comparison
Sacubitril/valsartan vs valsartan
Primary endpoint
Incident anaemia
Methodological detailsmulticentre, global
  • Multicentre
  • Global

Primary result

As reported in the abstract

Hazard ratio

0.76

95% CI 0.68–0.85

P < 0.001

By group

Sacubitril/valsartanvs Valsartan
HR 0.76 (95% CI 0.68–0.85); P < 0.001

Further findings

OutcomeSacubitril/valsartanValsartanEstimateP value
New iron therapy initiation8.1%10.0%HR 0.81 (95% CI 0.67–0.97)P = 0.026
Total HF hospitalizations and CV death, anaemiavs no anaemia at baseline · median follow-up 2.9 yearsadjusted rate ratio 1.31 (95% CI 1.12–1.54)P = 0.001
OutcomeDifference (g/dl) (95% CI)P value
Decline in haemoglobinSlower decline with sacubitril/valsartan0.1 (0.0–0.2)P = 0.005
  • Total HF hospitalizations and CV death, anaemia vs no anaemia at baseline: Anaemia 21.6 per 100 patient-years
  • Total HF hospitalizations and CV death, anaemia vs no anaemia at baseline: No anaemia 11.5 per 100 patient-years

Treatment effect on total HF hospitalizations and CV death across haemoglobin spectrum

Consistent across the haemoglobin spectrum
P for interaction = 0.60

Original publication

Sacubitril/Valsartan Reduces Incident Anaemia and Iron Therapy Utilization in Heart Failure: The PARAGON-HF Trial. Eur J Heart Fail. Published 1 September 2024. doi:10.1002/ejhf.3414

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