ARNI Superior To ARB In Reducing NT-proBNP In Patients With HFmrEF/HFpEF

31 May 2023 • Patients with an ejection fraction (EF) greater than 40% who were stabilized after recent worsening or de novo heart failure(HF) had a greater reduction in natriuretic peptides, less worsening renal function, but a higher rate of hypotension over 8 weeks with sacubitril-valsartan vs valsartan in the PARAGLIDE-HF trial. These findings were presented on the 21st of May at the European Society of Cardiology's scientific congress, Heart Failure 2023. The study was also published online simultaneously in the Journal of the American College of Cardiology.


  • In a pooled analysis of the PARAGON-HF and PARAGLIDE-HF studies, sacubitril/valsartan compared to valsartan reduced the composite CV endpoint of worsening HF and CV death (driven by worsening HF).
  • There were also reductions in the secondary composite renal outcome with sacubitril/valsartan compared to valsartan.
  • Early treatment benefit of sacubitril/valsartan was noted.
  • Regarding safety outcomes, SV compared to valsartan was associated with a trend toward increased symptomatic hypotension.

Among patients with EF >40% stabilized after WHF, sacubitril/valsartan led to greater reduction in plasma NT-proBNP levels and was associated with clinical benefit compared with valsartan alone, despite more symptomatic hypotension. The study provides additional support for SV use in patients with HFmrEF and HFpEF across care settings, especially when EF is less than normal, for CV and renal benefits.

Source: ACC | Read full story

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