Heart failure & cardiomyopathies
Urinary cGMP (Cyclic Guanosine Monophosphate)/BNP (B-Type Natriuretic Peptide) Ratio, Sacubitril/Valsartan, and Outcomes in Heart Failure With Reduced Ejection Fraction: An Analysis of the PARADIGM-HF Trial
Authors' conclusion
In patients with heart failure and reduced ejection fraction, higher ucGMP/BNP ratio was associated with better outcomes. Sacubitril/valsartan increased the ucGMP/BNP ratio, compared with enalapril, and the effect of sacubitril/valsartan on clinical outcomes was not modified by baseline ucGMP/BNP ratio.
Study context
- Population
- Patients with HFrEF in PARADIGM-HF with ucGMP/BNP ratio availableat baseline
- Participants
- 2,031 patients
- Comparison
- Baseline ucGMP/BNP ratio tertiles and outcomes; sacubitril/valsartan vs enalapril
- Primary endpoint
- Composite of:
- HF hospitalization
- CV death
Primary result
As reported in the abstract
Primary outcome by baseline ucGMP/BNP tertile
Each group vs tertile 1Hazard ratio (95% CI)
Tertile 2
0.57(0.45–0.71)
Tertile 3
0.54(0.43–0.67)
Further findings
| Outcome | Ratio of geometric mean ratios (95% CI) | |
|---|---|---|
| Change in ucGMP/BNP ratio from baseline · 1 month and 8 monthsSacubitril/valsartanvs Enalapril1 month; Pinteraction=0.19 across baseline tertiles | 1.38 (1.27–1.51) | |
| Change in ucGMP/BNP ratio from baseline · 1 month and 8 monthsSacubitril/valsartanvs Enalapril8 months; Pinteraction=0.91 across baseline tertiles | 1.32 (1.20–1.45) | |
| 0.512Ratio of geometric mean ratios (log scale) |
- Change in ucGMP/BNP ratio from baseline: n = 1959 at 1 month, 1746 at 8 months
Effect of sacubitril/valsartan vs enalapril on all outcomes, by baseline ucGMP/BNP tertile
- Effect consistent across tertiles for all outcomes
- P for interaction ≥ 0.31
Original publication
Urinary cGMP (Cyclic Guanosine Monophosphate)/BNP (B-Type Natriuretic Peptide) Ratio, Sacubitril/Valsartan, and Outcomes in Heart Failure With Reduced Ejection Fraction: An Analysis of the PARADIGM-HF Trial. Circ Heart Fail. Published 25 January 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →