PARADISE-MI – event rates and treatment effect of sacubitril/valsartan v ramipril by the presence or absence of transient pulmonary congestion and/or LVEF less or greater than 40

Abstract Background/Introduction Sacubitril/valsartan was compared to ramipril in patients with acute myocardial infarction the PARADISE-MI trial. In whole trial population sacubitril/valsartan did not reduce composite primary outcome of CV death or incident heart failure ramipril. Whether event rates and/or treatment effects vary different baseline characteristics is unknown. Purpose To investigate a) b) effect and c) safety by presence absence transient pulmonary congestion left ventricular ejection fraction (LVEF) ≤40%. Methods a double-blind, randomised clinical that 5661 an either LVEF ≤40% congestion. 3 groups were investigated: 1) (n=2012) 2) without (n=2596) 3) (n=1044). Results Patients (with ≤40%) more likely have had prior MI, CABG PCI, atrial fibrillation often treated mineralocorticoid receptor antagonists diuretics than no twice rate those congestion: 10.2 (95% CI 9.2–11.3) vs. 4.8 (4.3–5.5) events per 100 patient-years, respectively). intermediate (6.6, 5.5–7.9, patient-years). A similar pattern seen for components all secondary outcomes whether Clinical Events Committee investigator-reported analysed. The sacubitril/ valsartan versus between congestion/ subgroups. congestion/LVEF Conclusion higher effect, safety, consistent Funding Acknowledgement Type funding sources: Private company. Main source(s): Novartis