MedicalResearch.com Interview with:
Dr. Alvin Chandra MD first author and
Dr. Scott David Solomon M.D.
Director, Noninvasive Cardiology
Professor, Harvard Medical School
Brigham and Women’s Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In general, the quality of life of heart failure with reduced ejection fraction patients is quite impaired, and similar to that of patients on dialysis.
PARADIGM-HF was the largest trial of heart failure patients and showed that sacubitril/valsartan was superior to the gold-standard enalapril in reducing cardiovascular death, heart failure hospitalization and all-cause mortality. In addition, patients on sacubitril/valsartan, when compared to enalapril, showed significant improvement in overall quality of life.
In this study we looked in more detail at the individual components of “quality of life” and found that in virtually all domains and activities, patients who were randomized to sacubitril/valsartan reported improvement in their limitations compared to those who were randomized to enalapril. These activities included jogging, doing hobbies, and household chores, with the largest improvement seen in sexual activities limitations.
MedicalResearch.com: What should readers take away from your report?
Response: The goal of heart failure therapy in general is to keep patients living longer, out of the hospital and feeling better. While other drugs have been shown to reduce death and hospitalization in patients with heart failure, such as ACE inhibitors and angiotensin receptor blockers, and beta blockers, their effect on these measures of quality of life and improvement in symptom limitation have been less clear. Here we show improvement in many of the activities that heart failure patients really care about.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: We will continue to study what therapies can help patients with heart failure feel better and improve their limitations in addition to improving morbidity and mortality.
Disclosures: I have received research grants to my institution from Novartis and have consulted for Novartis.
Chandra A, Lewis EF, Claggett BL, et al. Effects of Sacubitril/Valsartan on Physical and Social Activity Limitations in Patients With Heart FailureA Secondary Analysis of the PARADIGM-HF Trial. JAMA Cardiol. Published online April 04, 2018. doi:10.1001/jamacardio.2018.0398
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