Global Differences in Heart Failure With Preserved Ejection Fraction
Key result
Sacubitril-valsartan treatment effect on heart failure hospitalizations and cardiovascular death was not modified by region (interaction P >0.05), despite event rates of 9 to 28 per 100 patient-years.
Why the study?
Heart failure with preserved ejection fraction is a global public health problem with important regional differences, prompting investigation within the global PARAGON-HF trial.
Are there regional differences in clinical characteristics, outcomes, and treatment effects of sacubitril/valsartan in patients with HFpEF?
Population
4796 patients with HFpEF from the PARAGON-HF trial
Comparison
Patients grouped according to geographic region
Design
Post-hoc analysis of a randomized clinical trial
Authors
Discussion
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Member takes
Implication
Should not change regional ARNI prescribing; extends evidence that future HFpEF trials must plan for large geographic outcome variation.
Study Design
Type
RCT (n=4,796)
Multicenter
Yes
Structured PICO
Are there regional differences in clinical characteristics, outcomes, and treatment effects of sacubitril/valsartan in patients with HFpEF?
P
Population
4,796 patients with heart failure with preserved ejection fraction from the global PARAGON-HF trial, analyzed to investigate regional differences in characteristics and outcomes.
I
Intervention
Sacubitril/valsartan
O
Outcome
Composite end point of total hospitalizations for HF and death from cardiovascular causescomposite
Main Result
p-value: p=>0.05
There are significant regional differences in clinical characteristics and baseline risk among global HFpEF patients, though the treatment effect of sacubitril/valsartan remains consistent across regions.
Cite This Study
Tromp et al. (2021) conducted an RCT in Heart failure with preserved ejection fraction (HFpEF) (n=4,796). Sacubitril/valsartan vs. Angiotensin Receptor Blocker was evaluated on total hospitalizations for HF and death from cardiovascular causes (p=>0.05). Sacubitril-valsartan treatment effect on heart failure hospitalizations and cardiovascular death was not modified by region (interaction P >0.05), despite event rates of 9 to 28 per 100 patient-years.