Dr. Vineet Mallik
MBBS, MD (Medicine), DM (Cardiology),
The Heart Clinic, Delhi.

The PARAGLIDE-HF trial and PARAGON-HF were multicenter, double-blind, randomized, active-controlled trials comparing sacubitril/valsartan vs. valsartan in patients with heart failure (HF) with mildly reduced or preserved left ventricular ejection fraction. The primary endpoint was the composite of total worsening HF events and cardiovascular death. Pre-specified renal composite endpoint was the secondary endpoint. Sacubitril/Valsartan significantly reduced total worsening HF events and cardiovascular death in both the primary pooled analysis of participants with recent worsening HF and in the pooled analysis of all participants. Treatment benefits were larger in those with LVEF ≤60% compared to those with LVEF >60%. Sacubitril / Valsartan was associated with lower rates of the renal composite endpoint in both analyses. These data provide support for the use of Sacubitril/Valsartan in patients with HF with preserved ejection fraction or mildly reduced, especially among those with an LVEF below normal range.

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National Library of Medicine