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. 2022 Jan 4;145(1):87-89.
doi: 10.1161/CIRCULATIONAHA.121.057429. Epub 2021 Nov 19.

Impact of Sacubitril/Valsartan Versus Ramipril on Total Heart Failure Events in the PARADISE-MI Trial

Marc A Pfeffer  1 , Brian Claggett  1 , Eldrin F Lewis  2 , Christopher B Granger  3 , Lars Køber  4 , Aldo P Maggioni  5 , Douglas L Mann  6 , John J V McMurray  7 , Jean-Lucien Rouleau  8 , Scott D Solomon  1 , Philippe Gabriel Steg  9 , Otavio Berwanger  10 , Maja Cikes  11 , Carmine G De Pasquale  12 , Alberto Fernandez  13 , Gerasimos Filippatos  14 , Karola Jering  1 , Ulf Landmesser  15 , Venugopal Menon  16 , Béla Merkely  17 , Mark C Petrie  1 , Ivo Petrov  18 , Morten Schou  19 , Michele Senni  20 , David Sim  21 , Peter van der Meer  22 , Martin Lefkowitz  23 , Yinong Zhou  23 , Yi Wang  23 , Eugene Braunwald  24
Affiliations

Impact of Sacubitril/Valsartan Versus Ramipril on Total Heart Failure Events in the PARADISE-MI Trial

Marc A Pfeffer et al. Circulation. .
No abstract available

Keywords: heart failure; myocardial infarction; ramipril; sacubitril/valsartan.

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Figures

Figure 1.
Figure 1.
Clinical Outcomes. Shown are Kaplan-Meier curves for the investigator-reported primary composite outcome, analyzed as time to first (A), and Nelson-Aalen event curves for total (first and recurrent) CEC adjudicated (B) and investigator-reported (C) primary events of total hospitalizations for heart failure, total outpatient episodes of symptomatic heart failure and cardiovascular death. (A) Investigator-reported time-to-first event: 443 patients (15.7%) in the sacubitril/valsartan group (cardiovascular death: 115, hospitalization: 231 and outpatient: 97) and 516 patients (18.2%) in the ramipril group (cardiovascular death: 111, hospitalization: 264 and outpatient: 141). (B) CEC adjudicated total primary events: 452 primary events in the sacubitril/valsartan group (240 hospitalizations, 44 outpatient episodes and 168 cardiovascular deaths) and 539 events in the ramipril group (286 hospitalizations, 62 outpatient episodes and 191 cardiovascular deaths). (C) Investigator-reported total primary events: 672 primary events in the sacubitril/valsartan group (395 hospitalizations, 122 outpatient episodes and 155 cardiovascular deaths) and 802 events in the ramipril group (447 hospitalizations, 176 outpatient episodes and 179 cardiovascular deaths).
Figure 1.
Figure 1.
Clinical Outcomes. Shown are Kaplan-Meier curves for the investigator-reported primary composite outcome, analyzed as time to first (A), and Nelson-Aalen event curves for total (first and recurrent) CEC adjudicated (B) and investigator-reported (C) primary events of total hospitalizations for heart failure, total outpatient episodes of symptomatic heart failure and cardiovascular death. (A) Investigator-reported time-to-first event: 443 patients (15.7%) in the sacubitril/valsartan group (cardiovascular death: 115, hospitalization: 231 and outpatient: 97) and 516 patients (18.2%) in the ramipril group (cardiovascular death: 111, hospitalization: 264 and outpatient: 141). (B) CEC adjudicated total primary events: 452 primary events in the sacubitril/valsartan group (240 hospitalizations, 44 outpatient episodes and 168 cardiovascular deaths) and 539 events in the ramipril group (286 hospitalizations, 62 outpatient episodes and 191 cardiovascular deaths). (C) Investigator-reported total primary events: 672 primary events in the sacubitril/valsartan group (395 hospitalizations, 122 outpatient episodes and 155 cardiovascular deaths) and 802 events in the ramipril group (447 hospitalizations, 176 outpatient episodes and 179 cardiovascular deaths).
Figure 1.
Figure 1.
Clinical Outcomes. Shown are Kaplan-Meier curves for the investigator-reported primary composite outcome, analyzed as time to first (A), and Nelson-Aalen event curves for total (first and recurrent) CEC adjudicated (B) and investigator-reported (C) primary events of total hospitalizations for heart failure, total outpatient episodes of symptomatic heart failure and cardiovascular death. (A) Investigator-reported time-to-first event: 443 patients (15.7%) in the sacubitril/valsartan group (cardiovascular death: 115, hospitalization: 231 and outpatient: 97) and 516 patients (18.2%) in the ramipril group (cardiovascular death: 111, hospitalization: 264 and outpatient: 141). (B) CEC adjudicated total primary events: 452 primary events in the sacubitril/valsartan group (240 hospitalizations, 44 outpatient episodes and 168 cardiovascular deaths) and 539 events in the ramipril group (286 hospitalizations, 62 outpatient episodes and 191 cardiovascular deaths). (C) Investigator-reported total primary events: 672 primary events in the sacubitril/valsartan group (395 hospitalizations, 122 outpatient episodes and 155 cardiovascular deaths) and 802 events in the ramipril group (447 hospitalizations, 176 outpatient episodes and 179 cardiovascular deaths).
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References

    1. Jering KS, Claggett B, Pfeffer MA, et al. Prospective ARNI versus ACE inhibitor trial to DetermIne Superiority in reducing heart failure Events after Myocardial Infarction ( PARADISE‐MI ): Design and Baseline Characteristics. Eur J Heart Fail 2021; published online April 22. - PubMed
    1. Pfeffer MA, Claggett B, Lewis EF, et al. Angiotensin Receptor-Neprilysin Inhibition in Acute Myocardial Infarction. N Engl J Med 2021; in press. - PubMed
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    1. McMurray JJV, Packer M, Desai AS, et al. Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure. N Engl J Med 2014;371: 993–1004. - PubMed
    1. Velazquez EJ, Morrow DA, DeVore AD, et al. Angiotensin–Neprilysin Inhibition in Acute Decompensated Heart Failure. N Engl J Med 2019;380:539–548. - PubMed

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