Evidence map›Paper›PMID 31736337›Full record

ArticleCirculation2020

Effects of Sacubitril-Valsartan Versus Valsartan in Women Compared With Men With Heart Failure and Preserved Ejection Fraction: Insights From PARAGON-HF.

John J V McMurray, Alice M Jackson, Carolyn S P Lam, Margaret M Redfield, Inder S Anand, Junbo Ge, Marty P Lefkowitz, Aldo P Maggioni, Felipe Martinez, Milton Packer and 20 more

2 registry-linked trialsOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 198 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
198citing papers in PubMed, 5 pooled it
32.2field-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
NCT05881720 phase4completednot on this mapstarted 2022, after this paper: background citation

Effect of Sacubitril/Valsartan Versus Valsartan on Left Ventricular Ejection Fraction and Biomarker in Heart Failure

TypeinterventionalSponsorDamanhour UniversityRan2022 to 2023Enrolled80ConditionsHeart FailureArmsSacubitril / Valsartan Oral Tablet, Valsartan 80 mg
3 · Its place in the literature

Who cites it

198 citing papers in PubMed, 5 syntheses or guidelines pooled it, 368 citations in OpenAlex.

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  6. Effects of natriuresis-guided diuretic therapy in men and women with acute heart failure: insights from PUSH-AHF.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
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138 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors at 2 institutions in 1 country.

John J V McMurrayBHF Cardiovascular Research Centre, University of Glasgow, UK (J.J.V.M., A.M.J., P.S.J.).
Alice M JacksonBHF Cardiovascular Research Centre, University of Glasgow, UK (J.J.V.M., A.M.J., P.S.J.).
Carolyn S P LamNational Heart Center Singapore and Duke-National University of Singapore (C.S.P.L.).
Margaret M RedfieldMayo Clinic, Rochester, MN (M.M.R.).
Inder S AnandUniversity of Minnesota, Minneapolis (I.S.A.).
Junbo GeShanghai Institute of Cardiovascular Diseases, China (J.G.).
Marty P LefkowitzNovartis Pharmaceuticals, East Hanover, NJ (M.P.L., A.R.R., S.V.S., V.C.S.).
Aldo P MaggioniNational Association of Hospital Cardiologists Research Center, Florence, Italy (A.P.M.).
Felipe MartinezNational University of Cordoba, Argentina (F.M.).
Milton PackerBaylor University Medical Center, Dallas, TX (M.P.).
Marc A PfefferCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.A.P., A.M.S., B.C., S.D.S.).
Burkert PieskeDepartment of Internal Medicine and Cardiology, German Center for Cardiovascular Research Partner Site Berlin, Germany (B.P.).
Adel R RizkalaNovartis Pharmaceuticals, East Hanover, NJ (M.P.L., A.R.R., S.V.S., V.C.S.).
Shalini V SabarwalNovartis Pharmaceuticals, East Hanover, NJ (M.P.L., A.R.R., S.V.S., V.C.S.).
Amil M ShahCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.A.P., A.M.S., B.C., S.D.S.).
Sanjiv J ShahDivision of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.).
Victor C ShiNovartis Pharmaceuticals, East Hanover, NJ (M.P.L., A.R.R., S.V.S., V.C.S.).
Dirk J van VeldhuisenDepartment of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (C.S.P.L., D.J.v.V.).
Faiez ZannadINSERM Centre d'Investigation Clinic 1433 and Universite de Lorraine, Centre Hospitalier Regional et Universitaire, Nancy, France (F.Z.).
Michael R ZileMedical University of South Carolina and the Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston (M.R.Z.).
Maja CikesDepartment of Cardiovascular Diseases, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Croatia (M.C.).
Eva GoncalvesovaDepartment of Heart Failure-Transplantation, National Cardiovascular Institute, Bratislava, Slovakia (E.G.).
Tzvetana KatovaClinic of Cardiology, National Cardiology Hospital, Sofia, Bulgaria (T.K.).
Anamaria KosztinHeart and Vascular Center, Semmelweis University, Budapest, Hungary (A.K.).
Malgorzata LelonekDepartment of Noninvasive Cardiology, Medical University of Lodz, Poland (M.L.).
Nancy SweitzerUniversity of Arizona Sarver Heart, Tucson (N.S.).
Orly VardenyMinneapolis VA Center for Care Delivery and Outcomes Research, University of Minnesota (O.V.).
Brian ClaggettCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.A.P., A.M.S., B.C., S.D.S.).
Pardeep S JhundBHF Cardiovascular Research Centre, University of Glasgow, UK (J.J.V.M., A.M.J., P.S.J.).
Scott D SolomonCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.A.P., A.M.S., B.C., S.D.S.).
Mayo Clinic in Arizona · USNorthwestern University · US

Funding

Mapping the Progression to HFpEF in the Elderly through Longitudinal Changes in Cardiac FunctionR01HL135008 · NHLBI · UT SOUTHWESTERN MEDICAL CENTER · PI Amil M Shah · 2017 to 2026
$11.5M
Mentoring patient-oriented research in deep phenotyping of cardiac function for heart failure preventionK24HL152008 · NHLBI · UT SOUTHWESTERN MEDICAL CENTER · PI SHAH, AMIL M · 2020 to 2024
$608k
British Heart Foundation FS/18/14/33330British Heart Foundation RE/18/6/34217NHLBI NIH HHS K24 HL152008NHLBI NIH HHS R01 HL135008
6 · The paper itself

Abstract

backgroundUnlike heart failure with reduced ejection fraction, there is no approved treatment for heart failure with preserved ejection fraction, the predominant phenotype in women. Therefore, there is a greater heart failure therapeutic deficit in women compared with men.

methodsIn a prespecified subgroup analysis, we examined outcomes according to sex in the PARAGON-HF trial (Prospective Comparison of ARNI With ARB Global Outcomes in Heart Failure With Preserved Ejection Fraction), which compared sacubitril-valsartan and valsartan in patients with heart failure with preserved ejection fraction. The primary outcome was a composite of first and recurrent hospitalizations for heart failure and death from cardiovascular causes. We also report secondary efficacy and safety outcomes.

resultsOverall, 2479 women (51.7%) and 2317 men (48.3%) were randomized. Women were older and had more obesity, less coronary disease, and lower estimated glomerular filtration rate and NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels than men. For the primary outcome, the rate ratio for sacubitril-valsartan versus valsartan was 0.73 (95% CI, 0.59-0.90) in women and 1.03 (95% CI, 0.84-1.25) in men (

conclusionsAs compared with valsartan, sacubitril-valsartan seemed to reduce the risk of heart failure hospitalization more in women than in men. Whereas the possible sex-related modification of the effect of treatment has several potential explanations, the present study does not provide a definite mechanistic basis for this finding. CLINICAL

trial registrationhttps://www.clinicaltrials.gov. Unique identifier: NCT01920711.

Indexed as

Sex FactorsAgedAged, 80 and overAminobutyratesAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug CombinationsFemaleHeart FailureHumansMaleMiddle AgedStroke VolumeTetrazolesValsartanAminobutyratesAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug Combinationssacubitril and valsartan sodium hydrate drug combinationTetrazolesValsartanheart failurehospitalizationneprilysinwomen

Identifiers

PMID31736337
PMCPMC12611550
OpenAlexW2987185485

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.