Heart failure & cardiomyopathies
Sacubitril/Valsartan vs Enalapril in Heart Failure Due to Chagas Disease: An Open-Label, Multicenter Randomized Clinical Trial
Primary result · Hierarchical composite (win ratio)Result — go to the resultStratified win ratio 1.52 95% CI 1.28–1.82Authors' conclusion
In patients with HF with reduced ejection fraction due to Chagas disease, there was no significant difference in clinical outcomes between sacubitril/valsartan and enalapril, but there was a greater reduction in NT-proBNP at 12 weeks in patients in the sacubitril/valsartan group.
Study context
- Population
- Patients with HFrEF (LVEF ≤40%, elevated NT-proBNP/BNP) due to Chagas disease, Argentina, Brazil, Colombia and Mexico
- Participants
- 462 vs 460
- Comparison
- Sacubitril/valsartan vs enalapril
- Sacubitril/valsartann = 462
- Enalapriln = 460reference
- Primary endpoint
- Hierarchical composite of:
- CV death
- Heart failure (HF) hospitalization
- Relative change in NT-proBNP (win ratio)
- Follow-up
- NT-proBNP change from baseline to 12 weeks
Methodological detailsmulticentre (83 sites)
- Multicentre (83 sites)
Primary result
Hierarchical composite (win ratio)
Stratified win ratio
1.52
95% CI 1.28–1.82
P < 0.001
As reported in the abstract
Further findings
CV death (hierarchical component) · median follow-up 25.2 months
Wins
First HF hospitalization (hierarchical component)
Wins
Decrease in NT-proBNP (hierarchical component) · 12 weeks Sacubitril/valsartan median 30.6% (IQR −54.3%–-0.9%) · Enalapril median 5.5% (IQR −31.9%–37.5%)
Wins
Original publication
Summarised from the published abstract; every number is checked against it