Heart failure & cardiomyopathiesSecondary analysis
Sacubitril/Valsartan in Patients With Heart Failure and Deterioration in Estimated Glomerular Filtration Rate (eGFR) to <30 mL/min/1.73 m2
- Post hoc analysis of the PARADIGM-HF and PARAGON-HF randomised trials
- parallel trial analyses
- time-updated Cox models
Authors' conclusion
Patients experiencing deterioration of kidney function to a value below eGFR 30 mL/min/1.73 m2 faced high risk of cardiovascular and kidney disease outcomes. Continuation of sacubitril/valsartan was associated with persistent clinical benefit and no incremental safety risk.
Study context
- Population
- HF patients in PARADIGM-HF and PARAGON-HF with deterioration in eGFR to <30 mL/min/1.73 m² during follow-up8,346 PARADIGM-HF
- Comparison
- Sacubitril/valsartan vs Renin-angiotensin system inhibitor
- Primary endpoint
- Primary outcome of each trial
Primary result
As reported in the abstract
eGFR <30 at least once in follow-up, PARADIGM-HF
691 (8.3%)
eGFR <30 at least once in follow-up, PARAGON-HF
613 (12.9%)
Primary outcome lower with sacubitril/valsartan vs RAS inhibitor regardless of kidney function deterioration, PARADIGM-HF
Pinteraction = 0.50
Primary outcome lower with sacubitril/valsartan vs RAS inhibitor regardless of kidney function deterioration, PARAGON-HF
Pinteraction = 0.64
Safety
Key safety outcomes
- Higher among patients with eGFR deterioration
- Similar between treatment groups, including among those who remained on treatment
Original publication
Summarised from the published abstract; every number is checked against it