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Angiotensin-neprilysin inhibition and renal outcomes in heart failure with preserved ejection fraction

Title: Angiotensin-neprilysin inhibition and renal outcomes in heart failure with preserved ejection fraction
Authors: Mc Causland FR; Lefkowitz MP; Claggett B; Anavekar NS; Senni M; Gori M; Jhund PS; McGrath MM; Packer M; Shi V; Van Veldhuisen DJ; Zannad F; Comin-Colet J; Pfeffer MA; McMurray JJV; Solomon SD
Contributors: Mc Causland, F; Lefkowitz, M; Claggett, B; Anavekar, N; Senni, M; Gori, M; Jhund, P; Mcgrath, M; Packer, M; Shi, V; Van Veldhuisen, D; Zannad, F; Comin-Colet, J; Pfeffer, M; Mcmurray, J; Solomon, S
Publisher Information: Lippincott Williams and Wilkins; US
Publication Year: 2020
Collection: Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive)
Subject Terms: Chronic; Heart failure; Renal insufficiency; Treatment outcome
Description: BACKGROUND: In patients with heart failure, chronic kidney disease is common and associated with a higher risk of renal events than in patients without chronic kidney disease. We assessed the renal effects of angiotensin/neprilysin inhibition in patients who have heart failure with preserved ejection fraction enrolled in the PARAGON-HF trial (Prospective Comparison of ARNI With ARB Global Outcomes in HF With Preserved Ejection Fraction). METHODS: In this randomized, double-blind, event-driven trial, we assigned 4822 patients who had heart failure with preserved ejection fraction to receive sacubitril/valsartan (n=2419) or valsartan (n=2403). Herein, we present the results of the prespecified renal composite outcome (time to first occurrence of either: ≥50% reduction in estimated glomerular filtration rate (eGFR), end-stage renal disease, or death from renal causes), the individual components of this composite, and the influence of therapy on eGFR slope. RESULTS: At randomization, eGFR was 63±19 mL·min–1·1.73 m–2. At study closure, the composite renal outcome occurred in 33 patients (1.4%) assigned to sacubitril/valsartan and 64 patients (2.7%) assigned to valsartan (hazard ratio, 0.50 [95% CI, 0.33–0.77]; P=0.001). The treatment effect on the composite renal end point did not differ according to the baseline eGFR (
Document Type: article in journal/newspaper
File Description: STAMPA
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/32845715; info:eu-repo/semantics/altIdentifier/wos/WOS:000576528800005; volume:142; issue:13; firstpage:1236; lastpage:1245; numberofpages:10; journal:CIRCULATION; https://hdl.handle.net/10281/373122
DOI: 10.1161/CIRCULATIONAHA.120.047643
Availability: https://hdl.handle.net/10281/373122; https://doi.org/10.1161/CIRCULATIONAHA.120.047643
Rights: info:eu-repo/semantics/closedAccess ; license:Tutti i diritti riservati ; license uri:iris.PRI01
Accession Number: edsbas.B321FA36
Database: BASE