Evidence map›Paper›PMID 31726194›Full record

Trial reportJournal of the American College of Cardiology2020

Prior Heart Failure Hospitalization, Clinical Outcomes, and Response to Sacubitril/Valsartan Compared With Valsartan in HFpEF.

Muthiah Vaduganathan, Brian L Claggett, Akshay S Desai, Stefan D Anker, Sergio V Perrone, Stefan Janssens, Davor Milicic, Juan L Arango, Milton Packer, Victor C Shi and 3 more

Registry-linked trialOpen access · greenAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01920711 (A Multicenter, Randomized, Double-blind, Parallel Group, Active-controlled Study to Evaluate the Efficacy and Safety of LCZ696 Compared to Valsartan, on Morbidity and Mortality in Heart Failure Patients), which is not on this map. Cited by 59 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 2 pooled it
11.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01920711 phase3completednot on this map

A Multicenter, Randomized, Double-blind, Parallel Group, Active-controlled Study to Evaluate the Efficacy and Safety of LCZ696 Compared to Valsartan, on Morbidity and Mortality in Heart Failure Patients (NYHA Class II-IV) With Preserved Ejection Fraction (PARAGON-HF)

TypeinterventionalSponsorNovartis PharmaceuticalsRan2014 to 2019Enrolled4,822ConditionsHeart Failure With Preserved Ejection FractionArmsLCZ696, Valsartan
3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 2 syntheses or guidelines pooled it, 143 citations in OpenAlex.

  1. Pooled it
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  9. Diuretic therapy as prognostic enrichment factor for clinical trials in patients with heart failure with reduced ejection fraction.Clinical research in cardiology : official journal of the German Cardiac Society · 2021
    Trial
  10. Review
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  12. ANMCO position paper: diagnosis and treatment of heart failure with preserved systolic function.European heart journal supplements : journal of the European Society of Cardiology · 2025
    Article
  13. Review
  14. Article
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  16. Emerging therapeutic frontiers in hypertension management.Frontiers in cardiovascular medicine · 2025
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 6 countries.

Muthiah VaduganathanCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: https://twitter.com/mvaduganathan.
Brian L ClaggettCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Akshay S DesaiCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: https://twitter.com/akshaydesaimd.
Stefan D AnkerDivision of Cardiology and Metabolism, Department of Cardiology and Berlin-Brandenburg Center for Regenerative Therapies; German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung), Berlin, Germany; Charité Universitätsmedizin, Berlin, Germany.
Sergio V PerroneInstituto Fleni, Buenos Aires, Argentina. Electronic address: https://twitter.com/svperrone.
Stefan JanssensDepartment of Cardiology, University Hospitals Leuven, Leuven, Belgium.
Davor MilicicDepartment of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia.
Juan L ArangoGuatemalan Heart Institute, Guatemala City, Guatemala.
Milton PackerBaylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas; Imperial College, London, United Kingdom.
Victor C ShiNovartis Pharmaceuticals, East Hanover, New Jersey.
Martin P LefkowitzNovartis Pharmaceuticals, East Hanover, New Jersey.
John J V McMurrayBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.
Scott D SolomonCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: ssolomon@bwh.harvard.edu.
Twitter (United States) · USBrigham and Women's Hospital · USNovartis (United States) · USBaylor University Medical Center · USBritish Heart Foundation · GBGerman Rheumatism Research Centre · DEKU Leuven · BEUniversity Hospital Centre Zagreb · HR

Funding

The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
NCATS NIH HHS UL1 TR002541
6 · The paper itself

Abstract

backgroundThe period shortly after hospitalization for heart failure (HF) represents a high-risk window for recurrent clinical events, including rehospitalization or death.

objectivesThis study sought to determine whether the efficacy and safety of sacubitril/valsartan varies in relation to the proximity to hospitalization for HF among patients with HF with preserved ejection fraction (HFpEF).

methodsIn this post hoc analysis of PARAGON-HF (Prospective Comparison of ARNI [Angiotensin Receptor-Neprilysin Inhibitor] with ARB [Angiotensin Receptor Blocker] Global Outcomes in HFpEF), we assessed the risk of clinical events and response to sacubitril/valsartan in relation to time from last HF hospitalization among patients with HFpEF (≥45%). The primary outcome was composite total HF hospitalizations and cardiovascular death, analyzed by using a semiparametric proportional rates method, stratified by geographic region.

resultsOf 4,796 validly randomized patients in PARAGON-HF, 622 (13%) were screened during hospitalization or within 30 days of prior hospitalization, 555 (12%) within 31 to 90 days, 435 (9%) within 91 to 180 days, and 694 (14%) after 180 days; 2,490 (52%) were never previously hospitalized. Over a median follow-up of 35 months, risk of total HF hospitalizations and cardiovascular death was inversely and nonlinearly associated with timing from prior HF hospitalization (p < 0.001). There was a gradient in relative risk reduction in primary events with sacubitril/valsartan from patients hospitalized within 30 days (rate ratio: 0.73; 95% confidence interval: 0.53 to 0.99) to patients never hospitalized (rate ratio: 1.00; 95% confidence interval: 0.80 to 1.24; trend in relative risk reduction: p

conclusionsRecent hospitalization for HFpEF identifies patients at high risk for near-term clinical progression. In the PARAGON-HF trial, the relative and absolute benefits of sacubitril/valsartan compared with valsartan in HFpEF appear to be amplified when initiated in the high-risk window after hospitalization and warrant prospective validation. (PARAGON-HF; NCT01920711).

Indexed as

AgedAged, 80 and overAminobutyratesAngiotensin II Type 1 Receptor BlockersAngiotensin Receptor AntagonistsBiphenyl CompoundsDouble-Blind MethodDrug CombinationsFemaleHeart FailureHospitalizationHumansMaleMiddle AgedStroke VolumeTetrazolesAminobutyratesAngiotensin II Type 1 Receptor BlockersAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug Combinationssacubitril and valsartan sodium hydrate drug combinationTetrazolesValsartanclinical outcomesheart failure with preserved ejection fractionhospitalizationsacubitril/valsartan

Identifiers

PMID31726194
PMCPMC7983315
OpenAlexW2985626563

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.