Title |
Angiotensin Receptor Neprilysin Inhibition in Heart Failure With Preserved Ejection Fraction Rationale and Design of the PARAGON-HF Trial
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Published in |
JACC: Heart Failure, June 2017
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DOI | 10.1016/j.jchf.2017.04.013 |
Pubmed ID | |
Authors |
Scott D. Solomon, Adel R. Rizkala, Jianjian Gong, Wenyan Wang, Inder S. Anand, Junbo Ge, Carolyn S.P. Lam, Aldo P. Maggioni, Felipe Martinez, Milton Packer, Marc A. Pfeffer, Burkert Pieske, Margaret M. Redfield, Jean L. Rouleau, Dirk J. Van Veldhuisen, Faiez Zannad, Michael R. Zile, Akshay S. Desai, Victor C. Shi, Martin P. Lefkowitz, John J.V. McMurray |
Abstract |
The PARAGON-HF (Prospective Comparison of ARNI with ARB Global Outcomes in HF With Preserved Ejection Fraction) trial is designed to determine the efficacy and safety of the angiotensin receptor neprilysin inhibitor sacubitril/valsartan compared with valsartan in patients with chronic heart failure and preserved ejection fraction (HFpEF). HFpEF is highly prevalent, associated with substantial morbidity and mortality, and in need of effective therapies that improve outcomes. The angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan, which has been shown to benefit patients with heart failure (HF) and reduced ejection fraction, demonstrated favorable physiologic effects in a phase II HFpEF trial. The PARAGON-HF trial is a randomized, double-blind, parallel group, active-controlled, event-driven trial comparing the long-term efficacy and safety of valsartan and sacubitril/valsartan in patients with chronic HFpEF (left ventricular ejection fraction ≥45%), New York Heart Association functional class II to IV symptoms, elevated natriuretic peptides, and evidence of structural heart disease. Before randomization, all patients entered sequential single-blind run-in periods to ensure tolerability of both drugs at half the target doses (i.e., valsartan titrated to 80 mg bid followed by sacubitril/valsartan 49/51 mg [100 mg] bid). The primary outcome is the composite of cardiovascular death and total (first and recurrent) HF hospitalizations. PARAGON-HF will determine whether sacubitril/valsartan is superior to angiotensin receptor blockade alone in patients with chronic symptomatic HFpEF. (Efficacy and Safety of LCZ696 Compared to Valsartan, on Morbidity and Mortality in Heart Failure Patients With Preserved Ejection Fraction [PARAGON-HF]; NCT01920711). |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 13 | 15% |
Spain | 10 | 12% |
United Kingdom | 5 | 6% |
Mexico | 2 | 2% |
Netherlands | 2 | 2% |
Italy | 2 | 2% |
Argentina | 2 | 2% |
Venezuela, Bolivarian Republic of | 2 | 2% |
Paraguay | 1 | 1% |
Other | 7 | 8% |
Unknown | 39 | 46% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 56 | 66% |
Practitioners (doctors, other healthcare professionals) | 17 | 20% |
Scientists | 7 | 8% |
Science communicators (journalists, bloggers, editors) | 5 | 6% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | <1% |
Unknown | 270 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 44 | 16% |
Student > Postgraduate | 25 | 9% |
Student > Bachelor | 24 | 9% |
Student > Doctoral Student | 23 | 8% |
Other | 23 | 8% |
Other | 61 | 23% |
Unknown | 71 | 26% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 138 | 51% |
Biochemistry, Genetics and Molecular Biology | 10 | 4% |
Pharmacology, Toxicology and Pharmaceutical Science | 9 | 3% |
Engineering | 6 | 2% |
Nursing and Health Professions | 5 | 2% |
Other | 21 | 8% |
Unknown | 82 | 30% |