https://m2.mtmt.hu/ hun 2026-09-22 10:13 JournalArticle 30935719 VALIDATED true Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX, United States Imperial College, London, United Kingdom Medical University of South Carolina, Charleston, United States Ralph H. Johnson Department, Veterans Affairs Medical Center, Charleston, SC, United States Department of Molecular and Clinical Medicine, University of Gothenburg, Sweden National Heart and Lung Institute, Imperial College, London, United Kingdom Institut de Cardiologie de Montréal, Université de Montréal, Canada Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden Department of Cardiology, Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark Department of Medicine, VA Medical Center, University of Minnesota, Minneapolis, United States Sarver Heart Center, University of Arizona, College of Medicine, Tucson, United States Department of Cardiology, Hospital Group Twente, Almelo, Hengelo, Netherlands Heart and Vascular Center, Semmelweis University, Budapest, Hungary Guatemalan Heart Institute University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital of Bucharest, Romania Department of Medicine, National Yang-Ming University, Taipei, Taiwan Cardiology Division, Cardiovascular Department, Hospital Papa Giovanni XXIII, Bergamo, Italy St Luke's Heart Institute, St. Luke's Medical Center, Taguig, Philippines National Research Center for Cardiology, Ministry of Health of the Russian Federation, Moscow, Russian Federation Novartis Pharmaceuticals Corporation, East Hanover, NJ, United States British Heart Foundation Cardiovascular Research Centre, University of Glasgow, United Kingdom Cited By :94 Export Date: 6 October 2021 CODEN: CIRCA Correspondence Address: Solomon, S.D.; Cardiovascular Division, 75 Francis Street, United States; email: ssolomon@rics.bwh.harvard.edu Chemicals/CAS: Aminobutyrates; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; sacubitril-valsartan; Tetrazoles 0 false 2026-09-09T12:06:02.849+0000 2022-11-24T18:59:05.877+0000 2019-11-27T11:29:09.586+0000 true 10055096 Nagy Regina /api/admin/10055096 Admin true 10055096 2024-10-08T12:57:34.634+0000 2022-11-24T18:59:06.265+0000 true 10015544 Csajbók Edit /api/admin/10015544 Admin true 10015544 true false true 24 24 /api/publicationtype/24 PublicationType 1 true 24 JournalArticle true 10000059 Article true 24 24 /api/publicationtype/24 PublicationType 1 true 24 JournalArticle /api/subtype/10000059 Szakcikk SubType 101 true 10000059 true 1 /api/category/1 Category true 1 Solomon, Scott D Sacubitril/Valsartan Across the Spectrum of Ejection Fraction in Heart Failure. true true /api/journal/1023 REVIEWED true false 1023 false 1023 true 0009-7322 1524-4539 Journal FOREIGN 141 5 352 361 352 10 2020 Background: While disease modifying therapies exist for heart failure (HF) with reduced left ventricular ejection fraction (LVEF), few options are available for patients in the higher range of LVEF (>40%). Sacubitril/valsartan has been compared with a renin-angiotensin- system (RAS) inhibitor alone in two similarly designed clinical trials of patients with reduced and preserved LVEF, permitting examination of its effects across the full spectrum of LVEF. Methods: We combined data from PARADIGM-HF (LVEF eligibility≤40%; n=8,399) and PARAGON-HF (LVEF eligibility≥45%; n=4,796) in a prespecified pooled analysis. We divided randomized patients into LVEF categories:≤22.5% (n=1269), >22.5% to 32.5% (n=3987), >32.5% to 42.5% (n=3143), > 42.5% to 52.5% (n=1427), > 52.5% to 62.5% (n=2166), >62.5% (n=1202). We assessed time to first cardiovascular death and HF hospitalization, its components, and total heart failure hospitlizations, all-cause mortality and non-cardiovascular mortality. Incidence rates and treatment effects were examined across categories of LVEF. Results: Among 13,195 randomized patients, we observed lower rates of cardiovascular death and HF hospitalization, but similar rates of non-cardiovascular death, among patients in the highest vs. lowest groups. Overall sacubitril/valsartan was superior to RAS inhibition for first cardiovascular death or heart failure hospitalization (HR 0.84, 95% CI 0.78, 0.90), cardiovascular death (HR 0.84, 95% CI 0.76, 0.92), heart failure hospitalization (HR 0.84, 95% CI 0.77, 0.91), and all-cause mortality (HR 0.88, 95% CI 0.81, 0.96). The effect of sacubitril/valsartan was modified by LVEF (treatment-by-continuous LVEF interaction p=0.02), and benefit appeared to be present for individuals with EF primarily below the normal range, although the treatment benefit for cardiovascular death diminished at a lower ejection fraction. We observed effect modification by LVEF on the efficacy of sacubitril/valsartan in both men and women with respect to composite total HF hospitalizations and cardiovascular death, although women derived benefit to higher ejection fractions. Conclusions:The therapeutic effects of sacubitril/valsartan, compared with a RAS inhibitor alone, vary by LVEF, with treatment benefits, particularly for heart failure hospitalization, that appear to extend to patients with heart failure and mildly reduced ejection fraction. These therapeutic benefits appeared to extend to a higher LVEF range in women compared with men. Clinical Trial Registration: URL: https://clinicaltrials.gov PARAGON-HF Unique Identifier: NCT01920711. 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0 18 15 18 15 D1 false false false false 2020-02-25T13:02:30.051+0000 Kardiológia Központ - Kardiológiai Tanszék (SE / AOK / K); Sportorvostan Tanszék (SE / AOK / K); Városmajori Szív- és Érgyógyászati Klinika (SE / AOK / K) 1 26 3 25 0 true Language 10002 /api/language/10002 Angol English true 2 true PersonAuthorship 88866900 /api/authorship/88866900 1 0.04 true false false Solomon Scott D true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 88866901 /api/authorship/88866901 2 0.04 false false false Vaduganathan Muthiah true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 88866902 /api/authorship/88866902 3 0.04 false false false Claggett Brian L true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 88866903 /api/authorship/88866903 4 0.04 false false false Packer Milton true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true 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true true PubMed PubMed http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=@@@&dopt=Abstract true true 17 true IDENTICAL 31736342 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=31736342&dopt=Abstract false true Keyword 1821279 /api/keyword/1821279 true true SjrRating 10758715 /api/sjrrating/10758715 2 0.0 journal RatingType 10002 /api/ratingtype/10002 sjr true true ClassificationExternal 2705 /api/classificationexternal/2705 true 2705 true D1 DIRECT true true /api/publication/30935719 <div class="JournalArticle Publication long-list"> <div class="authors"> <img title="Forrásközlemény" style="float: left" src="/frontend/resources/grid/publication-core-icon.png"> <img title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png"> <div class="autype autype0"> <span class="author-name" >Solomon Scott D </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Vaduganathan Muthiah </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Claggett Brian L </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Packer Milton </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Zile Michael </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Swedberg Karl </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Rouleau Jean </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Pfeffer Marc A </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Desai Akshay </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Lund Lars H </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Koeber Lars </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Anand Inder </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Sweitzer Nancy K </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Linssen Gerard </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10002691"><a href="/gui2/?type=authors&mode=browse&sel=10002691" target="_blank">Merkely Bela (<span class="authorship-author-name">Merkely Béla Péter</span> <span class="authorAux-mtmt"> Kardiológia</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Klinikum">K</span>/Városmajori Szív- és Érgyógyászati Klinika; <span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Klinikum">K</span>/<span title="Városmajori Szív- és Érgyógyászati Klinika">VAROSMAJOR_SZÍVÉRGYÓGY</span>/Kardiológia Központ - Kardiológiai Tanszék; <span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Klinikum">K</span>/<span title="Városmajori Szív- és Érgyógyászati Klinika">VAROSMAJOR_SZÍVÉRGYÓGY</span>/Sportorvostan Tanszék</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Arango Juan Luis </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Vinereanu Dragos </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Chen Chen-Huan </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Senni Michele </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Sibulo Antonio </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Boytsov Sergey </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Shi Victor </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Rizkala Adel </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Lefkowitz Martin </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >McMurray John J V </span> </div> </div> <div class="title"><a href="/gui2/?mode=browse&params=publication;30935719" target="_blank">Sacubitril/Valsartan Across the Spectrum of Ejection Fraction in Heart Failure.</a></div> <div> <span class="journal-title">CIRCULATION</span> <span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/0009-7322">0009-7322</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/1524-4539">1524-4539</a>)</span>: <span class="journal-volume">141</span> <span class="journal-issue">5</span> <span class="page"> pp 352-361 </span> <span class="year">(2020)</span> </div> <div class="pub-footer"> <span class="language" xmlns="http://www.w3.org/1999/html">Nyelv: Angol | </span> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1161/CIRCULATIONAHA.119.044586" target="_blank" href="https://doi.org/10.1161/CIRCULATIONAHA.119.044586"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000528029000005" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000528029000005"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="85076157482" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-85076157482"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="31736342" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=31736342&dopt=Abstract"> PubMed </a> </span> </span> <OnlyViewableByAuthor><div class="ratings"> <div class="journal-subject">Folyóirat szakterülete: Scopus - Cardiology and Cardiovascular Medicine&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;D1</div> <div class="journal-subject">Folyóirat szakterülete: Scopus - Physiology (medical)&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;D1</div> </div></OnlyViewableByAuthor> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 477</span> | Független: 376 | Függő: 101 | Nem jelölt: 0 | WoS jelölt: 451 | Scopus jelölt:&nbsp;449 | WoS/Scopus jelölt:&nbsp;477 | DOI jelölt:&nbsp;468 (Nem nyilvános:&nbsp;2) </div> <div class="publication-citation"> <a target="_blank" href="/api/publication?cond=citations.related;eq;30935719&sort=publishedYear,desc&sort=title"> Idézett közlemények száma: 4 </a> </div> <div class="mtid"><span class="long-pub-mtid">Közlemény: 30935719</span> | <span class="status-data status-VALIDATED"> Egyeztetett </span> Forrás Idéző | <span class="type-subtype">Folyóiratcikk ( Szakcikk ) </span> | <span class="pub-category">Tudományos</span> | <span class="publication-sourceOfData">PubMed XML</span> </div> <div class="lastModified">Utolsó módosítás: 2022.11.24. 19:59 Csajbók Edit (SE_KK_Admin5_CSE, admin) </div> <pre class="comment" style="margin-top: 0; margin-bottom: 0;"><u>Megjegyzés</u>: Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX, United States Imperial College, London, United Kingdom Medical University of South Carolina, Charleston, United States ...</pre> </div></div>