Does sacubitril/valsartan reduce NT-proBNP compared to enalapril, and does this reduction correlate with lower rates of cardiovascular death or heart failure hospitalization in patients with heart failure?
Sacubitril/valsartan is superior to enalapril in reducing NT-proBNP, a reduction that is prognostically linked to improved clinical outcomes in heart failure.
Patients who attained a significant reduction in NT-proBNP had a lower subsequent rate of cardiovascular death or HF hospitalization independent of the treatment group. Treatment with sacubitril/valsartan was nearly twice as likely as enalapril to reduce NT-proBNP to values ≤1,000 pg/ml. (Prospective Comparison of ARNI Angiotensin Receptor-Neprilysin Inhibitor with ACEI Angiotensin-Converting-Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial) PARADIGM-HF; NCT01035255.).
Zile et al. (Mon,) studied this question.