Heart failure & cardiomyopathiesSecondary analysis
Prevalent and Incident Anemia in PARADIGM-HF and the Effect of Sacubitril/Valsartan
- Secondary analysis of the PARADIGM-HF randomised trial
Authors' conclusion
Irrespective of anemia status, sacubitril/valsartan compared with enalapril, decreased mortality and hospitalization. Hemoglobin decreased less with sacubitril/valsartan and the incidence of new anemia was lower with sacubitril/valsartan.
Study context
- Population
- Patients with HFrEF; anemia = hemoglobin <120 g/L in women, <130 g/L in men at screening1,677 (20.4%) anemic
- Participants
- 8,239 patients
- Comparison
- Sacubitril/valsartan vs enalapril, by anemia status
- Primary endpoint
- CV death or HF hospitalization according to anemia status
Primary result
As reported in the abstract
CV death or HF hospitalization, by anemia status
Sacubitril/valsartan vs EnalaprilHazard ratio (95% CI)
with anemia
0.84(0.71–1.00)
without anemia
0.78(0.71–0.87)
Further findings
Decrease, g/L
| Outcome | Sacubitril/valsartan | Enalapril | mean difference (g/L) (95% CI) | P value | |
|---|---|---|---|---|---|
| Hemoglobin decrease from baseline · 12 months | 1.5 (95% CI 1.2–1.7) | 2.3 (95% CI 2.0–2.6) | 0.8 (0.5–1.2) | P < 0.001 | |
| −0.500.511.5Difference, g/L (linear scale) |
| Outcome | Sacubitril/valsartan | Enalapril | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Incident anemia · 12 months | 11.4% · 321 of 2,806 | 15.6% · 440 of 2,824 | 0.70 (0.60–0.81) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Findings in PARAGON-HF (sacubitril/valsartan vs valsartan)
- Findings similar in PARAGON-HF
Iron biomarkers
- Biomarker evidence of increased iron utilization with sacubitril/valsartan
Original publication
Prevalent and Incident Anemia in PARADIGM-HF and the Effect of Sacubitril/Valsartan. JACC Heart Fail. Published 12 April 2023. doi:10.1016/j.jchf.2022.12.012
Summarised from the published abstract; every number is checked against it