PARADIGM-HF

Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality

Patient / Population Intervention / Exposition Comparaison Critère de jugement

In 8,442 patients with HFrEF (EF ≤ 0.40), sacubitril/valsartan reduced CV death or hospitalisation for HF compared with enalapril.

8 442

Schéma

Double-blind RCT, terminated early

Critère

CV death or HF hospitalisation

Pertinence

Résultat21.8 % vs 26.5 % (HR 0.80). All-cause mortality also reduced.

McMurray JJV, et al. N Engl J Med. 2014;371(11):993-1004. 10.1056/NEJMoa1409077

Discussion et critique

Run-in period excluded intolerant patients (~ 20 %), which may inflate efficacy estimates. ARNI replaced ACEi as preferred RAAS-blocker in HFrEF guidelines.