Randomised controlled trial
Sacubitril-Valsartan for the Prevention of Anthracycline Cardiotoxicity in Patients With Elevated Cardiac Troponin I Concentration During Chemotherapy: A Double-Blind Randomized Placebo-Controlled Clinical Trial: The SARAH Trial
- Randomised controlled trial
- double-blind
- placebo-controlled
- pilot
Authors' conclusion
The SARAH trial (Sacubitril-Valsartan for the Prevention of Anthracycline Cardiotoxicity in Patients With Elevated hs-cTnI Concentrations During Chemotherapy) demonstrated the potential of sacubitril-valsartan therapy to reduce the incidence of left ventricular dysfunction, as assessed by global longitudinal strain, in patients with elevated high-sensitivity cardiac troponin I after anthracycline treatment.
Study context
- Population
- Patients with elevated cardiac troponin I during anthracycline chemotherapy (90% women, 80.7% breast cancer)
- Participants
- 114 patients
- Comparison
- Sacubitril-valsartan vs placebo
- Primary endpoint
- >15% reduction in global longitudinal strain from baseline
- Follow-up
- 6 months
Primary result
As reported in the abstract
Odds ratio
0.23
95% CI 0.07–0.75
P = 0.015
Events by treatment group
Sacubitril-valsartan vs Placebo
OR 0.23 (95% CI 0.07–0.75); P = 0.015
Secondary outcomes
| Outcome | P value |
|---|---|
| Change in global longitudinal strain | P < 0.001 |
Change in global longitudinal strain
- Sacubitril-valsartan: 2.5% improvement; placebo: 7.6% decline
Changes in cardiac troponin I and NT-proBNP
- No significant differences
Safety
events
| Outcome | Sacubitril-valsartan | Placebo | P value |
|---|---|---|---|
| Hypotension (SBP <100 mm Hg) | 8 | 1 | P = 0.032 |
Original publication
Sacubitril-Valsartan for the Prevention of Anthracycline Cardiotoxicity in Patients With Elevated Cardiac Troponin I Concentration During Chemotherapy: A Double-Blind Randomized Placebo-Controlled Clinical Trial: The SARAH Trial. Circulation. Published 13 November 2025. doi:10.1161/circulationaha.125.073322
Summarised from the published abstract; every number is checked against it