Related Experiment Video

Updated: Mar 1, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

11.1K

The effects of sacubitril/valsartan on coronary outcomes in PARADIGM-HF

Ulrik M Mogensen1, Lars Køber2, Søren L Kristensen2

  • 1BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK; Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.

American Heart Journal
|June 5, 2017
PubMed

Insights

Sacubitril/valsartan significantly reduced cardiovascular death and heart failure hospitalizations compared to enalapril. This angiotensin-receptor neprilysin inhibitor also improved coronary outcomes in patients with heart failure with reduced ejection fraction.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Angiotensin converting enzyme inhibitors (ACE-I) benefit patients with heart failure with reduced ejection fraction (HF-REF) and after myocardial infarction (MI).
  • The study compared sacubitril/valsartan, an angiotensin-receptor neprilysin inhibitor, with enalapril, an ACE-I, focusing on coronary outcomes.

Purpose of the Study:

  • To evaluate the effect of sacubitril/valsartan versus enalapril on coronary outcomes in the PARADIGM-HF trial.
  • To assess the impact on primary composite endpoint, a broader composite, and a coronary composite outcome.

Main Methods:

  • Analysis of data from 8399 patients in the PARADIGM-HF trial.
  • Comparison of sacubitril/valsartan and enalapril groups regarding cardiovascular death, HF hospitalization, MI, stroke, and coronary events.

Main Results:

  • Sacubitril/valsartan reduced the primary composite endpoint (CV death or HF hospitalization) by 20% (HR 0.80, P<.001).
  • Sacubitril/valsartan also reduced a broader composite outcome (including MI, stroke) by 17% (HR 0.83, P<.001).
  • A post hoc coronary composite outcome was reduced by 17% (HR 0.83, P<.001), with CV death being the only significantly reduced component.

Conclusions:

  • Sacubitril/valsartan demonstrated superiority over enalapril in reducing both the primary endpoint and coronary composite outcomes in PARADIGM-HF.
  • Further research is warranted to explore the effects of sacubitril/valsartan on atherothrombotic outcomes in high-risk populations.
Abstract

More Related Videos

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock07:39

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

Published on: August 16, 2021

4.2K

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
1.3K
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
428
Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

Antihypertensive Drugs: Angiotensin II Receptor Blockers

In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
2.9K
Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
1.6K
Heart Failure Drugs: &#946;-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
1.0K
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
1.6K