Publications by authors named "K Swedberg"
Background: Lower estimated glomerular filtration rate (eGFR) may be one of the major reasons for hesitation or failure to initiate potentially beneficial therapies in patients with heart failure (HF).
Objectives: This study sought to assess if the effects of sacubitril/valsartan (vs valsartan) on cardiovascular outcomes differ according to baseline kidney function in patients with HF with preserved ejection fraction.
Methods: The PARAGON-HF (Prospective Comparison of ARNI with ARB Global Outcomes in HF with Preserved Ejection Fraction) trial was global clinical trial of 4,796 patients with chronic HF and left ventricular ejection fraction (LVEF) ≥45% randomly assigned to sacubitril/valsartan or valsartan.
Aims: Beta-blockers may inhibit neprilysin activity and conversely, neprilysin inhibition may have a sympatho-inhibitory action. Consequently, sacubitril/valsartan may have a greater effect in patients not receiving a beta-blocker compared to those treated with a beta-blocker.
Methods And Results: We examined the effect of sacubitril/valsartan compared to enalapril on outcomes according to background beta-blocker treatment in the 8399 patients with heart failure with reduced ejection fraction enrolled in PARADIGM-HF.
Aims: Resting heart rate (HR) is a strong risk marker in patients with heart failure (HF), but the clinical implications of visit-to-visit changes in HR (ΔHR) are less well established. We aimed to explore the association between ΔHR and subsequent outcomes in a pooled dataset of two well-characterized cohorts of patients with HF across the full range of left ventricular ejection fraction (LVEF).
Methods And Results: PARADIGM-HF and PARAGON-HF were randomized trials testing sacubitril/valsartan versus enalapril or valsartan, respectively, in patients with HF and LVEF ≤40% (PARADIGM-HF) or LVEF ≥45% (PARAGON-HF).
Article Synopsis
- The study investigated the impact of hypotension on heart failure outcomes using data from the PARADIGM-HF trial, focusing on the differences between asymptomatic and symptomatic hypotension.
- Out of 8,399 patients, 16% had only asymptomatic hypotension, while 11.1% experienced symptomatic hypotension, with those having symptomatic hypotension being older and having more cardiovascular issues.
- Despite the risks associated with either type of hypotension, the heart failure medication sacubitril/valsartan showed consistent effectiveness and safety compared to enalapril across all patient groups.
Article Synopsis
- Sacubitril/valsartan is a medication that helps reduce the risk of cardiovascular death and hospital stays due to heart failure in people with chronic heart failure (HF), especially among older patients with other health issues.* -
- The study analyzed data from two major trials (PARADIGM-HF and PARAGON-HF) to determine the impact of sacubitril/valsartan on all-cause hospitalizations in patients with different levels of heart function (measured as left ventricular ejection fraction - LVEF).* -
- Results showed that sacubitril/valsartan lowered the risk of all-cause hospitalization compared to standard heart medications, with a median follow-up of about 2.5