PARADIGM-HF: New Drug Class Outclasses ACE-I in Chronic HF Patients with chronic heart failure who take a newly developed drug that has effects both within and beyond the renin-angiotensin system, instead of the old-standby ACE inhibitor enalapril, will have fewer HF hospitalizations and die less often from cardiovascular causes, suggests a phase 3 trial that is huge both in size and its potential impact on clinical practice. An editorial accompanying the PARADIGM-HF report proposed that LCZ696 may prove to be the first disruptive agent to the heart-failure treatment algorithm, which has remained essentially unchanged for a decade The PARADIGM study shows that, for the management of stable outpatients with heart failure and a reduced left ventricular ejection fraction [HFREF] and, crucially, increased plasma concentrations of natriuretic peptides, LCZ696 is substantially superior to an ACE inhibitor (and by implication angiotensin-receptor blockers), in terms of reducing both morbidity and mortality. Patients also felt better on the newer agent; a small but highly significant effect. McMurray JJV et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med 2014; DOI:10.156/NEJMoa1409077 (Shortened from Medscape News & Perspective, for personal use)
Posted on: Tue, 02 Sep 2014 10:25:44 +0000
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