Key result
Sacubitril/valsartan improves composite outcomes ~52% vs enalapril in Chagas HF, driven by lower NT-proBNP.
Why the study?
Limited data exist on therapeutic options for heart failure due to Chagas’ disease, necessitating evaluation of sacubitril/valsartan versus enalapril in this population.
Does sacubitril/valsartan improve clinical endpoints and reduce natriuretic peptides compared to enalapril in patients with heart failure from Chagas' disease?
RCT (n=922)
Open-label
Randomized
Yes
Does sacubitril/valsartan improve clinical endpoints and reduce natriuretic peptides compared to enalapril in patients with heart failure from Chagas' disease?
This review highlights that sacubitril/valsartan improves outcomes and reduces natriuretic peptides in patients with Chagas' disease-related heart failure compared to enalapril.
May support sacubitril/valsartan in Chagas HF; leaves open confirmation in larger outcome trials.
Heart failure is a common manifestation of Chagas’ disease and results in significant morbidity and mortality in affected patients. In light of limited data on therapeutic options for heart failure due to Chagas’ disease, the PARACHUTE-HF trial aimed to compare the effects of sacubitril/valsartan versus enalapril on clinical endpoints and changes in natriuretic peptides in this population. This mini-review contextualizes the results of the trial, which demonstrated that sacubitril/valsartan led to significant improvements in outcomes driven primarily by a reduction in natriuretic peptides.
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Abramov et al. (2026) conducted an RCT in Heart failure with reduced ejection fraction due to Chagas' disease (n=922). Sacubitril/valsartan vs. Enalapril 10 mg twice daily was evaluated on Hierarchical composite of time to cardiovascular death, time to first HF hospitalization, or relative change in natriuretic peptides between baseline and week 12 (Win ratio 1.52, 95% CI 1.28-1.82). Sacubitril/valsartan significantly improved the primary hierarchical composite outcome compared to enalapril in patients with heart failure due to Chagas' disease (win ratio 1.52), driven primarily by reductions in NT-proBNP.
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