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http://hdl.handle.net/2445/178508
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DC Field | Value | Language |
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dc.contributor.author | McMurray, John J.V. | - |
dc.contributor.author | Packer, Milton | - |
dc.contributor.author | Desai, Akshay S. | - |
dc.contributor.author | Gong, Jianjian | - |
dc.contributor.author | Lefkowitz, Martin P. | - |
dc.contributor.author | Rizkala, Adel R. | - |
dc.contributor.author | Rouleau, Jean L. | - |
dc.contributor.author | Shi, Victor C. | - |
dc.contributor.author | Solomon, Scott D. | - |
dc.contributor.author | Swedberg, Karl | - |
dc.contributor.author | Zile, Michael R. | - |
dc.contributor.author | Comín Colet, Josep | - |
dc.contributor.author | PARADIGM-HF Investigators and Committees | - |
dc.date.accessioned | 2021-06-17T15:33:43Z | - |
dc.date.available | 2021-06-17T15:33:43Z | - |
dc.date.issued | 2014-09-11 | - |
dc.identifier.issn | 0028-4793 | - |
dc.identifier.uri | http://hdl.handle.net/2445/178508 | - |
dc.description.abstract | Background: we compared the angiotensin receptor-neprilysin inhibitor LCZ696 with enalapril in patients who had heart failure with a reduced ejection fraction. In previous studies, enalapril improved survival in such patients. Methods: in this double-blind trial, we randomly assigned 8442 patients with class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either LCZ696 (at a dose of 200 mg twice daily) or enalapril (at a dose of 10 mg twice daily), in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure, but the trial was designed to detect a difference in the rates of death from cardiovascular causes. Results: the trial was stopped early, according to prespecified rules, after a median follow-up of 27 months, because the boundary for an overwhelming benefit with LCZ696 had been crossed. At the time of study closure, the primary outcome had occurred in 914 patients (21.8%) in the LCZ696 group and 1117 patients (26.5%) in the enalapril group (hazard ratio in the LCZ696 group, 0.80; 95% confidence interval [CI], 0.73 to 0.87; P<0.001). A total of 711 patients (17.0%) receiving LCZ696 and 835 patients (19.8%) receiving enalapril died (hazard ratio for death from any cause, 0.84; 95% CI, 0.76 to 0.93; P<0.001); of these patients, 558 (13.3%) and 693 (16.5%), respectively, died from cardiovascular causes (hazard ratio, 0.80; 95% CI, 0.71 to 0.89; P<0.001). As compared with enalapril, LCZ696 also reduced the risk of hospitalization for heart failure by 21% (P<0.001) and decreased the symptoms and physical limitations of heart failure (P=0.001). The LCZ696 group had higher proportions of patients with hypotension and nonserious angioedema but lower proportions with renal impairment, hyperkalemia, and cough than the enalapril group. Conclusions: LCZ696 was superior to enalapril in reducing the risks of death and of hospitalization for heart failure. (Funded by Novartis; PARADIGM-HF ClinicalTrials.gov number, NCT01035255). | - |
dc.format.extent | 12 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Massachusetts Medical Society | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1056/NEJMoa1409077 | - |
dc.relation.ispartof | New England Journal of Medicine, 2014, vol. 371, num. 11, p. 993-1004 | - |
dc.relation.uri | https://doi.org/10.1056/NEJMoa1409077 | - |
dc.rights | (c) Massachusetts Medical Society, 2014 | - |
dc.source | Articles publicats en revistes (Ciències Clíniques) | - |
dc.subject.classification | Angiotensines | - |
dc.subject.classification | Insuficiència cardíaca | - |
dc.subject.classification | Ús terapèutic | - |
dc.subject.other | Angiotensins | - |
dc.subject.other | Heart failure | - |
dc.subject.other | Therapeutic use | - |
dc.title | Angiotensin-neprilysin inhibition versus enalapril in heart failure | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 674831 | - |
dc.date.updated | 2021-06-17T15:33:44Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 25176015 | - |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) |
Files in This Item:
File | Description | Size | Format | |
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674831.pdf | 645.39 kB | Adobe PDF | View/Open |
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