Preserved Heart Failure Trial Misses Endpoint, But Drug May Benefit Some Patients

The number of patients with heart failure with preserved ejection fraction is on the rise, and the search is on for a therapy that can improve health outcomes in this group of patients for whom no approved therapies are available. In a Hot Line Session at the European Society of Cardiology Congress, 2019, the results of the Prospective Comparison of ARNI with ARB Global Outcomes in HF With Preserved Ejection Fraction (PARAGON-HF), sponsored by Novartis, and led by Professor Scott Solomon of the Brigham and Women's Hospital Boston and Professor John McMurray from the University of Glasgow were presented. PARAGON-HF is the largest, randomized clinical trial of heart failure patients with preserved ejection fraction. The PARAGON-HF investigators reported that, overall, the drug sacubitril-valsartan did not significantly reduce heart failure hospitalizations and cardiovascular death compared to valsartan alone, but the data suggest benefit for patients in the lower part of the ejection fraction range studied, for which there currently exists no approved therapies. The results are published simultaneously in The New England Journal of Medicine . Co-chair of the study, Professor John McMurray, Professor of Cardiology at the University of Glasgow's BHF , said: "Heart failure with preserved ejection fraction accounts for about half of all patients with heart failure, there are currently no approved therapies for a condition with substantial morbidity," said study co-chair John McMurray, of the British Heart Foundation (BHF) Cardiovascular Research Centre, University of Glasgow.