TY - JOUR
T1 - Angiotensin-neprilysin inhibition versus enalapril in heart failure.
AU - Mamas, Mamas
AU - McMurray, John J V
AU - Packer, Milton
AU - Desai, Akshay S.
AU - Gong, Jianjian
AU - Lefkowitz, Martin P.
AU - Rizkala, Adel R.
AU - Rouleau, Jean L.
AU - Shi, Victor C.
AU - Solomon, Scott D.
AU - Swedberg, Karl
AU - Zile, Michael R.
AU - PARADIGM-HF Investigators, [Unknown]
PY - 2014
Y1 - 2014
N2 - We compared the angiotensin receptor-neprilysin inhibitor LCZ696 with enalapril in patients who had heart failure with a reduced ejection fraction. In previous studies, enalapril improved survival in such patients. In this double-blind trial, we randomly assigned 8442 patients with class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either LCZ696 (at a dose of 200 mg twice daily) or enalapril (at a dose of 10 mg twice daily), in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure, but the trial was designed to detect a difference in the rates of death from cardiovascular causes. The trial was stopped early, according to prespecified rules, after a median follow-up of 27 months, because the boundary for an overwhelming benefit with LCZ696 had been crossed. At the time of study closure, the primary outcome had occurred in 914 patients (21.8%) in the LCZ696 group and 1117 patients (26.5%) in the enalapril group (hazard ratio in the LCZ696 group, 0.80; 95% confidence interval [CI], 0.73 to 0.87; P
AB - We compared the angiotensin receptor-neprilysin inhibitor LCZ696 with enalapril in patients who had heart failure with a reduced ejection fraction. In previous studies, enalapril improved survival in such patients. In this double-blind trial, we randomly assigned 8442 patients with class II, III, or IV heart failure and an ejection fraction of 40% or less to receive either LCZ696 (at a dose of 200 mg twice daily) or enalapril (at a dose of 10 mg twice daily), in addition to recommended therapy. The primary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure, but the trial was designed to detect a difference in the rates of death from cardiovascular causes. The trial was stopped early, according to prespecified rules, after a median follow-up of 27 months, because the boundary for an overwhelming benefit with LCZ696 had been crossed. At the time of study closure, the primary outcome had occurred in 914 patients (21.8%) in the LCZ696 group and 1117 patients (26.5%) in the enalapril group (hazard ratio in the LCZ696 group, 0.80; 95% confidence interval [CI], 0.73 to 0.87; P
U2 - 10.1056/NEJMoa1409077
DO - 10.1056/NEJMoa1409077
M3 - Article
C2 - 25176015
SN - 1533-4406
VL - 371
SP - 993
EP - 1004
JO - New England Journal Of Medicine
JF - New England Journal Of Medicine
IS - 11
ER -
