PARADIGM-HF
Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality
Doente / População Intervenção / Exposição Comparação Desfecho
In 8,442 patients with HFrEF (EF ≤ 0.40), sacubitril/valsartan reduced CV death or hospitalisation for HF compared with enalapril.
N
8442
Desenho
Double-blind RCT, terminated early
Desfecho
CV death or HF hospitalisation
Relevância
1
Resultado21.8 % 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
Discussão e crítica
Run-in period excluded intolerant patients (~ 20 %), which may inflate efficacy estimates. ARNI replaced ACEi as preferred RAAS-blocker in HFrEF guidelines.