Baseline Characteristics of Patients With Heart Failure and Preserved Ejection Fraction in the PARAGON-HF Trial
Исходные характеристики пациентов с сердечной недостаточностью и сохраненной фракцией выброса, включенных в исследование PARAGON-HF
2018-07-01
SCID: 54.1/7ju2hdb4
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N-terminal pro-B-type natriuretic peptidePARAGON-HF trialchronic kidney diseaseheart failure with preserved ejection fractionsacubitril/valsartan
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Abstract (AI)
BACKGROUND: To describe the baseline characteristics of patients with heart failure and preserved left ventricular ejection fraction enrolled in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF) comparing sacubitril/valsartan to valsartan in reducing morbidity and mortality. METHODS AND RESULTS: We report key demographic, clinical, and laboratory findings, and baseline therapies, of 4822 patients randomized in PARAGON-HF, grouped by factors that influence criteria for study inclusion. We further compared baseline characteristics of patients enrolled in PARAGON-HF with those patients enrolled in other recent trials of heart failure with preserved ejection fraction (HFpEF). Among patients enrolled from various regions (16% Asia-Pacific, 37% Central Europe, 7% Latin America, 12% North America, 28% Western Europe), the mean age of patients enrolled in PARAGON-HF was 72.7±8.4 years, 52% of patients were female, and mean left ventricular ejection fraction was 57.5%, similar to other trials of HFpEF. Most patients were in New York Heart Association class II, and 38% had ≥1 hospitalizations for heart failure within the previous 9 months. Diabetes mellitus (43%) and chronic kidney disease (47%) were more prevalent than in previous trials of HFpEF. Many patients were prescribed angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (85%), β-blockers (80%), calcium channel blockers (36%), and mineralocorticoid receptor antagonists (24%). As specified in the protocol, virtually all patients were on diuretics, had elevated plasma concentrations of N-terminal pro-B-type natriuretic peptide (median, 911 pg/mL; interquartile range, 464-1610), and structural heart disease. CONCLUSIONS: PARAGON-HF represents a contemporary group of patients with HFpEF with similar age and sex distribution compared with prior HFpEF trials but higher prevalence of comorbidities. These findings provide insights into the impact of inclusion criteria on, and regional variation in, HFpEF patient characteristics. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01920711.
Key Findings
1
Diabetes mellitus and chronic kidney disease affected 43% and 47% of participants, respectively, representing higher comorbidity prevalence than in previous HFpEF trials.
2
Most patients were in NYHA class II, while 38% had at least one heart-failure hospitalization during the preceding nine months.
3
Nearly all participants received diuretics and had elevated NT-proBNP concentrations and structural heart disease; common baseline therapies included ACE inhibitors or ARBs, β-blockers, calcium channel blockers, and mineralocorticoid receptor antagonists.
4
PARAGON-HF enrolled 4,822 patients with HFpEF across five global regions to compare sacubitril/valsartan with valsartan for morbidity and mortality outcomes.
5
Participants had a mean age of 72.7±8.4 years, 52% were women, and mean left ventricular ejection fraction was 57.5%, consistent with prior HFpEF trials.
Research Object
Patients with heart failure and preserved left ventricular ejection fraction enrolled in the PARAGON-HF trial
Research Subject
Baseline demographic, clinical, laboratory, treatment, and comorbidity characteristics of the enrolled HFpEF patients
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2018-07-01
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