After a heart attack, sacubitril-valsartan no better than ramipril for heart-failure prevention

Reuters Health - 10/11/2021 - Sacubitril-valsartan is no more effective at preventing heart failure or death from cardiovascular causes than ramipril among patients who have suffered an acute myocardial infarction, according to results of the PARADISE-MI trial.

The combination, sold under the brand name Entresto by Novartis, failed to meet the prespecified threshold of a 15% reduction in the primary outcome, which occurred in 11.9% of the 2,830 sacubitril-valsartan patients versus 13.2% of the 2,831 getting ramipril (P=0.17).

The rates of death from any cause were 7.5% and 8.5%, respectively, and the combined risks of hospitalization for heart failure or death from cardiovascular causes were 10.9% versus 11.8%. Neither was statistically significant, the researchers report in the New England Journal of Medicine.

The two treatments showed comparable tolerability, Dr. Marc A. Pfeffer of Brigham and Women's Hospital and Harvard Medical School, in Boston, and colleagues founds. Side effects led to discontinuation among 12.6% of sacubitril-valsartan patients compared with 13.4% of the volunteers randomly assigned to the ramipril group.

Novartis paid for the study, which was done on patients who had just had their heart attack but were left with a reduced left ventricular ejection fraction, transient pulmonary congestion, or both. The volunteers could not have a history of heart failure at enrollment.

The findings were originally presented at the American College of Cardiology's 70th Annual Scientific Session in May.

SOURCE: https://bit.ly/3CSvOxY The New England Journal of Medicine, online November 10, 2021.

By Reuters Staff



Posted on 10 November, 202116 November, 2021