Open Access Research Article Article ID: JCMC-5-170

    Sacubitril/Valsartan versus enalapril in nonischemic heart failure in Paradigm-Hf trial

    Mohammed Habib*

    Background: We compared the angiotensin receptor–neprilysin inhibitor LCZ696 (sacubitril/valsartan) with enalapril in patients who had nonischemic heart failure with a reduced ejection fraction. 

    Methods: In this double-blind trial, we randomly assigned 8442 patients with class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either LCZ696 (at a dose of 200 mg twice daily) or enalapril (at a dose of 10 mg twice daily), in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure, but the trial was designed to detect a difference in the rates of death from cardiovascular causes.

    Results: The trial was stopped early, according to prespecified rules, after a median follow up of 27 months, because the boundary for an overwhelming benefit with LCZ696 had been crossed. The ischemic patients were 5036 (60%) patients and non-ischemic patients were 3363 (40%) patients. In ischemic and in non-ischemic group the LCZ696 was superior to enalapril for reduce primary outcome and CV death (P< 0.001). In LCZ696 group: the primary outcome had occurred in 339 patients (20.16 %) in the non-ischemic group and 575 patients (22.9 %) in the ischemic group (P: 0.03). A total of 199 patients (11.8%) in non-ischemic group and 359 patients in ischemic group (14.3%) died from cardiovascular causes (P: 0.01). and no significant difference between in CV death and primary outcome in enalapril group in the ischemic and non-ischemic patients

    Conclusions: LCZ696 was superior to enalapril in reducing the risks of cardiovascular death and hospitalization for heart failure in ischemic and non-ischemic heart failure.


    Published on: Oct 18, 2018 Pages: 46-47

    Full Text PDF Full Text HTML DOI: 10.17352/2455-2976.000070
    CrossMark Publons Harvard Library HOLLIS Search IT Semantic Scholar Get Citation Base Search Scilit OAI-PMH ResearchGate Academic Microsoft GrowKudos Universite de Paris UW Libraries SJSU King Library SJSU King Library NUS Library McGill DET KGL BIBLiOTEK JCU Discovery Universidad De Lima WorldCat VU on WorldCat


    Global Views

    Case Reports

    Peertechz Tweets

    Pinterest on JCMC

    Google Reviews 11