Baseline characteristics of patients with heart failure and preserved ejection fraction in the PARAGON-HF trial

Scott D. Solomon, Adel R. Rizkala, Martin P. Lefkowitz, Victor C. Shi, Jianjian Gong, Nagesh Anavekar, Stefan D. Anker, Juan L. Arango, Jose L. Arenas, Dan Atar, Turia Ben-Gal, Sergey A. Boytsov, Chen Huan Chen, Vijay K. Chopra, John Cleland, Josep Comin-Colet, Hans Dirk Duengen, Luis E. Echeverría Correa, Gerasimos Filippatos, Andreas J. FlammerMichel Galinier, Armando Godoy, Eva Goncalvesova, Stefan Janssens, Tzvetana Katova, Lars Køber, Małgorzata Lelonek, Gerard Linssen, Lars H. Lund, Eileen O'Meara, Béla Merkely, Davor Milicic, Byung Hee Oh, Sergio V. Perrone, Naresh Ranjith, Yoshihiko Saito, Jose F. Saraiva, Sanjiv Shah, Petar M. Seferovic, Michele Senni, Antonio S. Sibulo, David Sim, Nancy K. Sweitzer, Jyrki Taurio, Dragos Vinereanu, Bojan Vrtovec, Jiří Widimský, Mehmet B. Yilmaz, Jingmin Zhou, Robert Zweiker, Inder S. Anand, Junbo Ge, Carolyn S.P. Lam, Aldo P. Maggioni, Felipe Martinez, Milton Packer, Marc A. Pfeffer, Burkert Pieske, Margaret May Redfield, Jean L. Rouleau, Dirk J. Van Veldhuisen, Faiez Zannad, Michael R. Zile, John J.V. McMurray

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: To describe the baseline characteristics of patients with heart failure and preserved left ventricular ejection fraction enrolled in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF) comparing sacubitril/valsartan to valsartan in reducing morbidity and mortality. Methods and Results: We report key demographic, clinical, and laboratory findings, and baseline therapies, of 4822 patients randomized in PARAGON-HF, grouped by factors that influence criteria for study inclusion. We further compared baseline characteristics of patients enrolled in PARAGON-HF with those patients enrolled in other recent trials of heart failure with preserved ejection fraction (HFpEF). Among patients enrolled from various regions (16% Asia-Pacific, 37% Central Europe, 7% Latin America, 12% North America, 28% Western Europe), the mean age of patients enrolled in PARAGON-HF was 72.7±8.4 years, 52% of patients were female, and mean left ventricular ejection fraction was 57.5%, similar to other trials of HFpEF. Most patients were in New York Heart Association class II, and 38% had ≥1 hospitalizations for heart failure within the previous 9 months. Diabetes mellitus (43%) and chronic kidney disease (47%) were more prevalent than in previous trials of HFpEF. Many patients were prescribed angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (85%), β-blockers (80%), calcium channel blockers (36%), and mineralocorticoid receptor antagonists (24%). As specified in the protocol, virtually all patients were on diuretics, had elevated plasma concentrations of N-terminal pro-B-type natriuretic peptide (median, 911 pg/mL; interquartile range, 464-1610), and structural heart disease. Conclusions: PARAGON-HF represents a contemporary group of patients with HFpEF with similar age and sex distribution compared with prior HFpEF trials but higher prevalence of comorbidities. These findings provide insights into the impact of inclusion criteria on, and regional variation in, HFpEF patient characteristics. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01920711.

Original languageEnglish (US)
Article numbere004962
JournalCirculation: Heart Failure
Volume11
Issue number7
DOIs
StatePublished - Jul 1 2018

Fingerprint

Heart Failure
Angiotensin Receptor Antagonists
Valsartan
Stroke Volume
Mineralocorticoid Receptor Antagonists
Neprilysin
Sex Distribution
Angiotensin Receptors
Latin America
Brain Natriuretic Peptide
Age Distribution
Calcium Channels
North America
Chronic Renal Insufficiency
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Comorbidity
Heart Diseases
Diabetes Mellitus
Hospitalization

Keywords

  • angiotensin receptor antagonists
  • clinical trial
  • endopeptidases
  • heart failure, diastolic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Solomon, S. D., Rizkala, A. R., Lefkowitz, M. P., Shi, V. C., Gong, J., Anavekar, N., ... McMurray, J. J. V. (2018). Baseline characteristics of patients with heart failure and preserved ejection fraction in the PARAGON-HF trial. Circulation: Heart Failure, 11(7), [e004962]. https://doi.org/10.1161/CIRCHEARTFAILURE.118.004962

Baseline characteristics of patients with heart failure and preserved ejection fraction in the PARAGON-HF trial. / Solomon, Scott D.; Rizkala, Adel R.; Lefkowitz, Martin P.; Shi, Victor C.; Gong, Jianjian; Anavekar, Nagesh; Anker, Stefan D.; Arango, Juan L.; Arenas, Jose L.; Atar, Dan; Ben-Gal, Turia; Boytsov, Sergey A.; Chen, Chen Huan; Chopra, Vijay K.; Cleland, John; Comin-Colet, Josep; Duengen, Hans Dirk; Echeverría Correa, Luis E.; Filippatos, Gerasimos; Flammer, Andreas J.; Galinier, Michel; Godoy, Armando; Goncalvesova, Eva; Janssens, Stefan; Katova, Tzvetana; Køber, Lars; Lelonek, Małgorzata; Linssen, Gerard; Lund, Lars H.; O'Meara, Eileen; Merkely, Béla; Milicic, Davor; Oh, Byung Hee; Perrone, Sergio V.; Ranjith, Naresh; Saito, Yoshihiko; Saraiva, Jose F.; Shah, Sanjiv; Seferovic, Petar M.; Senni, Michele; Sibulo, Antonio S.; Sim, David; Sweitzer, Nancy K.; Taurio, Jyrki; Vinereanu, Dragos; Vrtovec, Bojan; Widimský, Jiří; Yilmaz, Mehmet B.; Zhou, Jingmin; Zweiker, Robert; Anand, Inder S.; Ge, Junbo; Lam, Carolyn S.P.; Maggioni, Aldo P.; Martinez, Felipe; Packer, Milton; Pfeffer, Marc A.; Pieske, Burkert; Redfield, Margaret May; Rouleau, Jean L.; Van Veldhuisen, Dirk J.; Zannad, Faiez; Zile, Michael R.; McMurray, John J.V.

In: Circulation: Heart Failure, Vol. 11, No. 7, e004962, 01.07.2018.

Research output: Contribution to journalArticle

Solomon, SD, Rizkala, AR, Lefkowitz, MP, Shi, VC, Gong, J, Anavekar, N, Anker, SD, Arango, JL, Arenas, JL, Atar, D, Ben-Gal, T, Boytsov, SA, Chen, CH, Chopra, VK, Cleland, J, Comin-Colet, J, Duengen, HD, Echeverría Correa, LE, Filippatos, G, Flammer, AJ, Galinier, M, Godoy, A, Goncalvesova, E, Janssens, S, Katova, T, Køber, L, Lelonek, M, Linssen, G, Lund, LH, O'Meara, E, Merkely, B, Milicic, D, Oh, BH, Perrone, SV, Ranjith, N, Saito, Y, Saraiva, JF, Shah, S, Seferovic, PM, Senni, M, Sibulo, AS, Sim, D, Sweitzer, NK, Taurio, J, Vinereanu, D, Vrtovec, B, Widimský, J, Yilmaz, MB, Zhou, J, Zweiker, R, Anand, IS, Ge, J, Lam, CSP, Maggioni, AP, Martinez, F, Packer, M, Pfeffer, MA, Pieske, B, Redfield, MM, Rouleau, JL, Van Veldhuisen, DJ, Zannad, F, Zile, MR & McMurray, JJV 2018, 'Baseline characteristics of patients with heart failure and preserved ejection fraction in the PARAGON-HF trial', Circulation: Heart Failure, vol. 11, no. 7, e004962. https://doi.org/10.1161/CIRCHEARTFAILURE.118.004962
Solomon, Scott D. ; Rizkala, Adel R. ; Lefkowitz, Martin P. ; Shi, Victor C. ; Gong, Jianjian ; Anavekar, Nagesh ; Anker, Stefan D. ; Arango, Juan L. ; Arenas, Jose L. ; Atar, Dan ; Ben-Gal, Turia ; Boytsov, Sergey A. ; Chen, Chen Huan ; Chopra, Vijay K. ; Cleland, John ; Comin-Colet, Josep ; Duengen, Hans Dirk ; Echeverría Correa, Luis E. ; Filippatos, Gerasimos ; Flammer, Andreas J. ; Galinier, Michel ; Godoy, Armando ; Goncalvesova, Eva ; Janssens, Stefan ; Katova, Tzvetana ; Køber, Lars ; Lelonek, Małgorzata ; Linssen, Gerard ; Lund, Lars H. ; O'Meara, Eileen ; Merkely, Béla ; Milicic, Davor ; Oh, Byung Hee ; Perrone, Sergio V. ; Ranjith, Naresh ; Saito, Yoshihiko ; Saraiva, Jose F. ; Shah, Sanjiv ; Seferovic, Petar M. ; Senni, Michele ; Sibulo, Antonio S. ; Sim, David ; Sweitzer, Nancy K. ; Taurio, Jyrki ; Vinereanu, Dragos ; Vrtovec, Bojan ; Widimský, Jiří ; Yilmaz, Mehmet B. ; Zhou, Jingmin ; Zweiker, Robert ; Anand, Inder S. ; Ge, Junbo ; Lam, Carolyn S.P. ; Maggioni, Aldo P. ; Martinez, Felipe ; Packer, Milton ; Pfeffer, Marc A. ; Pieske, Burkert ; Redfield, Margaret May ; Rouleau, Jean L. ; Van Veldhuisen, Dirk J. ; Zannad, Faiez ; Zile, Michael R. ; McMurray, John J.V. / Baseline characteristics of patients with heart failure and preserved ejection fraction in the PARAGON-HF trial. In: Circulation: Heart Failure. 2018 ; Vol. 11, No. 7.
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abstract = "Background: To describe the baseline characteristics of patients with heart failure and preserved left ventricular ejection fraction enrolled in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF) comparing sacubitril/valsartan to valsartan in reducing morbidity and mortality. Methods and Results: We report key demographic, clinical, and laboratory findings, and baseline therapies, of 4822 patients randomized in PARAGON-HF, grouped by factors that influence criteria for study inclusion. We further compared baseline characteristics of patients enrolled in PARAGON-HF with those patients enrolled in other recent trials of heart failure with preserved ejection fraction (HFpEF). Among patients enrolled from various regions (16{\%} Asia-Pacific, 37{\%} Central Europe, 7{\%} Latin America, 12{\%} North America, 28{\%} Western Europe), the mean age of patients enrolled in PARAGON-HF was 72.7±8.4 years, 52{\%} of patients were female, and mean left ventricular ejection fraction was 57.5{\%}, similar to other trials of HFpEF. Most patients were in New York Heart Association class II, and 38{\%} had ≥1 hospitalizations for heart failure within the previous 9 months. Diabetes mellitus (43{\%}) and chronic kidney disease (47{\%}) were more prevalent than in previous trials of HFpEF. Many patients were prescribed angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (85{\%}), β-blockers (80{\%}), calcium channel blockers (36{\%}), and mineralocorticoid receptor antagonists (24{\%}). As specified in the protocol, virtually all patients were on diuretics, had elevated plasma concentrations of N-terminal pro-B-type natriuretic peptide (median, 911 pg/mL; interquartile range, 464-1610), and structural heart disease. Conclusions: PARAGON-HF represents a contemporary group of patients with HFpEF with similar age and sex distribution compared with prior HFpEF trials but higher prevalence of comorbidities. These findings provide insights into the impact of inclusion criteria on, and regional variation in, HFpEF patient characteristics. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01920711.",
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TY - JOUR

T1 - Baseline characteristics of patients with heart failure and preserved ejection fraction in the PARAGON-HF trial

AU - Solomon, Scott D.

AU - Rizkala, Adel R.

AU - Lefkowitz, Martin P.

AU - Shi, Victor C.

AU - Gong, Jianjian

AU - Anavekar, Nagesh

AU - Anker, Stefan D.

AU - Arango, Juan L.

AU - Arenas, Jose L.

AU - Atar, Dan

AU - Ben-Gal, Turia

AU - Boytsov, Sergey A.

AU - Chen, Chen Huan

AU - Chopra, Vijay K.

AU - Cleland, John

AU - Comin-Colet, Josep

AU - Duengen, Hans Dirk

AU - Echeverría Correa, Luis E.

AU - Filippatos, Gerasimos

AU - Flammer, Andreas J.

AU - Galinier, Michel

AU - Godoy, Armando

AU - Goncalvesova, Eva

AU - Janssens, Stefan

AU - Katova, Tzvetana

AU - Køber, Lars

AU - Lelonek, Małgorzata

AU - Linssen, Gerard

AU - Lund, Lars H.

AU - O'Meara, Eileen

AU - Merkely, Béla

AU - Milicic, Davor

AU - Oh, Byung Hee

AU - Perrone, Sergio V.

AU - Ranjith, Naresh

AU - Saito, Yoshihiko

AU - Saraiva, Jose F.

AU - Shah, Sanjiv

AU - Seferovic, Petar M.

AU - Senni, Michele

AU - Sibulo, Antonio S.

AU - Sim, David

AU - Sweitzer, Nancy K.

AU - Taurio, Jyrki

AU - Vinereanu, Dragos

AU - Vrtovec, Bojan

AU - Widimský, Jiří

AU - Yilmaz, Mehmet B.

AU - Zhou, Jingmin

AU - Zweiker, Robert

AU - Anand, Inder S.

AU - Ge, Junbo

AU - Lam, Carolyn S.P.

AU - Maggioni, Aldo P.

AU - Martinez, Felipe

AU - Packer, Milton

AU - Pfeffer, Marc A.

AU - Pieske, Burkert

AU - Redfield, Margaret May

AU - Rouleau, Jean L.

AU - Van Veldhuisen, Dirk J.

AU - Zannad, Faiez

AU - Zile, Michael R.

AU - McMurray, John J.V.

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background: To describe the baseline characteristics of patients with heart failure and preserved left ventricular ejection fraction enrolled in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF) comparing sacubitril/valsartan to valsartan in reducing morbidity and mortality. Methods and Results: We report key demographic, clinical, and laboratory findings, and baseline therapies, of 4822 patients randomized in PARAGON-HF, grouped by factors that influence criteria for study inclusion. We further compared baseline characteristics of patients enrolled in PARAGON-HF with those patients enrolled in other recent trials of heart failure with preserved ejection fraction (HFpEF). Among patients enrolled from various regions (16% Asia-Pacific, 37% Central Europe, 7% Latin America, 12% North America, 28% Western Europe), the mean age of patients enrolled in PARAGON-HF was 72.7±8.4 years, 52% of patients were female, and mean left ventricular ejection fraction was 57.5%, similar to other trials of HFpEF. Most patients were in New York Heart Association class II, and 38% had ≥1 hospitalizations for heart failure within the previous 9 months. Diabetes mellitus (43%) and chronic kidney disease (47%) were more prevalent than in previous trials of HFpEF. Many patients were prescribed angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (85%), β-blockers (80%), calcium channel blockers (36%), and mineralocorticoid receptor antagonists (24%). As specified in the protocol, virtually all patients were on diuretics, had elevated plasma concentrations of N-terminal pro-B-type natriuretic peptide (median, 911 pg/mL; interquartile range, 464-1610), and structural heart disease. Conclusions: PARAGON-HF represents a contemporary group of patients with HFpEF with similar age and sex distribution compared with prior HFpEF trials but higher prevalence of comorbidities. These findings provide insights into the impact of inclusion criteria on, and regional variation in, HFpEF patient characteristics. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01920711.

AB - Background: To describe the baseline characteristics of patients with heart failure and preserved left ventricular ejection fraction enrolled in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF) comparing sacubitril/valsartan to valsartan in reducing morbidity and mortality. Methods and Results: We report key demographic, clinical, and laboratory findings, and baseline therapies, of 4822 patients randomized in PARAGON-HF, grouped by factors that influence criteria for study inclusion. We further compared baseline characteristics of patients enrolled in PARAGON-HF with those patients enrolled in other recent trials of heart failure with preserved ejection fraction (HFpEF). Among patients enrolled from various regions (16% Asia-Pacific, 37% Central Europe, 7% Latin America, 12% North America, 28% Western Europe), the mean age of patients enrolled in PARAGON-HF was 72.7±8.4 years, 52% of patients were female, and mean left ventricular ejection fraction was 57.5%, similar to other trials of HFpEF. Most patients were in New York Heart Association class II, and 38% had ≥1 hospitalizations for heart failure within the previous 9 months. Diabetes mellitus (43%) and chronic kidney disease (47%) were more prevalent than in previous trials of HFpEF. Many patients were prescribed angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (85%), β-blockers (80%), calcium channel blockers (36%), and mineralocorticoid receptor antagonists (24%). As specified in the protocol, virtually all patients were on diuretics, had elevated plasma concentrations of N-terminal pro-B-type natriuretic peptide (median, 911 pg/mL; interquartile range, 464-1610), and structural heart disease. Conclusions: PARAGON-HF represents a contemporary group of patients with HFpEF with similar age and sex distribution compared with prior HFpEF trials but higher prevalence of comorbidities. These findings provide insights into the impact of inclusion criteria on, and regional variation in, HFpEF patient characteristics. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01920711.

KW - angiotensin receptor antagonists

KW - clinical trial

KW - endopeptidases

KW - heart failure, diastolic

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JO - Circulation: Heart Failure

JF - Circulation: Heart Failure

SN - 1941-3297

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