Global Differences in Heart Failure With Preserved Ejection Fraction: The PARAGON-HF Trial.
Aged
Aminobutyrates
/ therapeutic use
Angiotensin Receptor Antagonists
/ therapeutic use
Biphenyl Compounds
/ therapeutic use
Double-Blind Method
Drug Combinations
Female
Global Health
Heart Failure
/ drug therapy
Hospitalization
/ statistics & numerical data
Humans
Male
Neprilysin
/ therapeutic use
Quality of Life
Risk Factors
Stroke Volume
Valsartan
/ therapeutic use
atrial fibrillation
coronary artery disease
heart failure
prevalence
risk factors
Journal
Circulation. Heart failure
ISSN: 1941-3297
Titre abrégé: Circ Heart Fail
Pays: United States
ID NLM: 101479941
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
pubmed:
20
4
2021
medline:
12
10
2021
entrez:
19
4
2021
Statut:
ppublish
Résumé
Heart failure with preserved ejection fraction (HFpEF) is a global public health problem with important regional differences. We investigated these differences in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF), the largest and most inclusive global HFpEF trial. We studied differences in clinical characteristics, outcomes, and treatment effects of sacubitril/valsartan in 4796 patients with HFpEF from the PARAGON-HF trial, grouped according to geographic region. Regional differences in patient characteristics and comorbidities were observed: patients from Western Europe were oldest (mean 75±7 years) with the highest prevalence of atrial fibrillation/flutter (36%); Central/Eastern European patients were youngest (mean 71±8 years) with the highest prevalence of coronary artery disease (50%); North American patients had the highest prevalence of obesity (65%) and diabetes (49%); Latin American patients were younger (73±9 years) and had a high prevalence of obesity (53%); and Asia-Pacific patients had a high prevalence of diabetes (44%), despite a low prevalence of obesity (26%). Rates of the primary composite end point of total hospitalizations for HF and death from cardiovascular causes were lower in patients from Central Europe (9 per 100 patient-years) and highest in patients from North America (28 per 100 patient-years), which was primarily driven by a greater number of total hospitalizations for HF. The effect of treatment with sacubitril-valsartan was not modified by region (interaction Among patients with HFpEF recruited worldwide in PARAGON-HF, there were important regional differences in clinical characteristics and outcomes, which may have implications for the design of future clinical trials. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01920711.
Sections du résumé
BACKGROUND
Heart failure with preserved ejection fraction (HFpEF) is a global public health problem with important regional differences. We investigated these differences in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF), the largest and most inclusive global HFpEF trial.
METHODS
We studied differences in clinical characteristics, outcomes, and treatment effects of sacubitril/valsartan in 4796 patients with HFpEF from the PARAGON-HF trial, grouped according to geographic region.
RESULTS
Regional differences in patient characteristics and comorbidities were observed: patients from Western Europe were oldest (mean 75±7 years) with the highest prevalence of atrial fibrillation/flutter (36%); Central/Eastern European patients were youngest (mean 71±8 years) with the highest prevalence of coronary artery disease (50%); North American patients had the highest prevalence of obesity (65%) and diabetes (49%); Latin American patients were younger (73±9 years) and had a high prevalence of obesity (53%); and Asia-Pacific patients had a high prevalence of diabetes (44%), despite a low prevalence of obesity (26%). Rates of the primary composite end point of total hospitalizations for HF and death from cardiovascular causes were lower in patients from Central Europe (9 per 100 patient-years) and highest in patients from North America (28 per 100 patient-years), which was primarily driven by a greater number of total hospitalizations for HF. The effect of treatment with sacubitril-valsartan was not modified by region (interaction
CONCLUSIONS
Among patients with HFpEF recruited worldwide in PARAGON-HF, there were important regional differences in clinical characteristics and outcomes, which may have implications for the design of future clinical trials. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01920711.
Identifiants
pubmed: 33866828
doi: 10.1161/CIRCHEARTFAILURE.120.007901
doi:
Substances chimiques
Aminobutyrates
0
Angiotensin Receptor Antagonists
0
Biphenyl Compounds
0
Drug Combinations
0
Valsartan
80M03YXJ7I
Neprilysin
EC 3.4.24.11
sacubitril and valsartan sodium hydrate drug combination
WB8FT61183
Banques de données
ClinicalTrials.gov
['NCT01920711']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e007901Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR001424
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG059988
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK092923
Pays : United States
Organisme : NHLBI NIH HHS
ID : R21 HL085375
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL069771
Pays : United States