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January 10, 2018American Heart JournalOpen Access

Rationale and design of the comParIson Of sacubitril/valsartaN versus Enalapril on Effect on nt-pRo-bnp in patients stabilized from an acute Heart Failure episode (PIONEER-HF) trial

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Why the study?

Does in-hospital initiation of sacubitril/valsartan improve NT-proBNP levels compared to enalapril in patients stabilized from acute decompensated heart failure with reduced ejection fraction?

Population

Planned 882 medically stable patients >18 years of age with an EF <40% and an amino terminal-pro b-type…

Comparison

In-hospital initiation of sacubitril/valsartan… vs Enalapril titrated to 10 mg by mouth twice daily…

Design

Other, 1:1, double-blind

Follow-up

12 weeks

Authors

EVEric J. VelazquezDMDavid A. MorrowADAdam D. DeVore

Discussion

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Overview

PIONEER-HF RCT tests in-hospital sacubitril/valsartan initiation in stabilized ADHF; extends prior ARNI evidence to acute setting.

Structured PICO

Does in-hospital initiation of sacubitril/valsartan improve NT-proBNP levels compared to enalapril in patients stabilized from acute decompensated heart failure with reduced ejection fraction?

P
Population
Planned 882 medically stable patients >18 years of age with an EF <40% and an amino terminal-pro b-type natriuretic peptide >1600 pg/mL or b-type natriuretic peptide >400 pg/mL, stabilized following hospitalization for acute decompensated HF.
I
Intervention
In-hospital initiation of sacubitril/valsartan titrated to 97/103 mg by mouth twice daily for 8 weeks, followed by open-label sacubitril/valsartan for 4 weeks.
C
Comparator
Enalapril titrated to 10 mg by mouth twice daily for 8 weeks, followed by open-label sacubitril/valsartan for 4 weeks.
O
Outcome
Time-averaged proportional change in amino terminal-pro b-type natriuretic peptide from baseline through weeks 4 and 8.surrogate

The PIONEER-HF trial is designed to evaluate the safety and efficacy of initiating sacubitril/valsartan in-hospital for patients stabilized after acute decompensated heart failure.

Cite This Study

Velazquez et al. (2018) studied this question.

synapsesocial.com/papers/6a7cffb7a3b6fd5035d59cc1https://doi.org/10.1016/j.ahj.2018.01.004
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