Therapy in heart failure has been to focus the neurohormonal pathways such as the renin-angiotensin-aldosterone system. Natriuretic peptides are metabolized by neprilysin enzyme. The LCZ696 is a new class of drug that inhibits the enzyme neprilysin. A total of 8436 patients with chronic heart failure functional class II-IV were included, elevated levels of NT-ProBNP and/or ejection fraction ≤40% randomized 1:1 to enalapril 10 mg or 200 mg LCZ696.
The primary end point was a composite of cardiovascular death and hospitalization for heart failure. Cardiovascular mortality in LCZ696 group was 13.3% versus 16.5% in the enalapril group (p <0.001). The hospitalizations for heart failure also favored the new drug group 12.8% versus 15.6% (p <0.001). The observed benefit was maintained in almost all subgroups of patients.
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John McMurray
2014-08-31
Original title: Results of the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial (PARADIGM-HF).
