Evidence map›Paper›PMID 40265602›Full record

Trial reportJournal of the American Heart Association2025

Prognostic Significance of Nutritional Scores in Patients With Heart Failure: Insights From the PARAGON-HF Trial.

Henri Lu, Brian L Claggett, Masatoshi Minamisawa, John W Ostrominski, Alberto Foà, Maria A Pabón, Arzu Kalayci, Muthiah Vaduganathan, Maja Cikes, Amil M Shah and 11 more

Registry-linked trialAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American Heart Association, 2025. 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 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
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

7 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Tumour necrosis factor-Frontiers in nutrition · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Henri LuDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0002-9074-6505
Brian L ClaggettDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0002-4215-9218
Masatoshi MinamisawaDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.
John W OstrominskiDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0002-2866-9414
Alberto FoàDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0003-1216-4478
Maria A PabónDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0003-1883-0654
Arzu KalayciDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0001-8555-5686
Muthiah VaduganathanDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0003-0885-1953
Maja CikesUniversity of Zagreb School of Medicine, Department of Cardiovascular Diseases University Hospital Center Zagreb Zagreb Croatia.ORCID 0000-0002-4772-5549
Amil M ShahDivision of Cardiovascular Medicine University of Texas Southwestern Medical Center Dallas TX USA.ORCID 0000-0003-1056-4451
Akshay S DesaiDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0002-1443-0701
John J V McMurrayBritish Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health University of Glasgow Glasgow United Kingdom.ORCID 0000-0002-6317-3975
Pardeep S JhundBritish Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health University of Glasgow Glasgow United Kingdom.ORCID 0000-0003-4306-5317
Milton PackerBaylor Heart and Vascular Institute, Baylor University Medical Center Dallas TX USA.ORCID 0000-0003-1828-2387
Martin LefkowitzNovartis Pharmaceutical Corporation East Hanover NJ USA.ORCID 0000-0002-8830-6316
Jean L RouleauInstitut de Cardiologie de Montréal, Université de Montréal Montreal QC Canada.ORCID 0000-0002-5353-3877
Michael R ZileRalph H Johnson Department of Veterans Affairs Health Care System Charleston SC USA.ORCID 0000-0001-7076-221X
Faiez ZannadUniversité de Lorraine, Centre d'Investigation Clinique-Plurithématique Inserm 1433, Centre Hospitalier Régional Universitaire Nancy France.ORCID 0000-0001-7456-1570
Sheila M HegdeDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0001-8157-8899
Scott D SolomonDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0003-3698-9597
Hicham SkaliDivision of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.ORCID 0000-0002-5629-4138

Funding

Noninvasive Cardiovascular Imaging Research Training ProgramT32HL094301 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI Marcelo F DI CARLI · 2010 to 2026
$7.8M
NHLBI NIH HHS T32 HL094301
6 · The paper itself

Abstract

backgroundThe Controlling Nutritional Status (CONUT) and Geriatric Nutritional Risk Index (GNRI) are indices that identify individuals at risk of malnutrition. Our study sought to examine the incidence and prognostic implications of abnormal CONUT and/or GNRI in patients with heart failure with preserved ejection fraction. METHODS AND

resultsThe CONUT score and GNRI were serially analyzed in this post hoc analysis of the PARAGON-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin-Receptor Blockers Global Outcomes in Heart Failure With Preserved Ejection Fraction) trial. A CONUT score >2 or GNRI ≤98 was considered to be abnormal. The association between abnormal CONUT and/or GNRI (analyzed using a time-updated approach) and total heart failure hospitalizations and cardiovascular death was analyzed. Other outcomes included cardiovascular death, all-cause death, total heart failure hospitalizations, first all-cause hospitalization, and first noncardiovascular hospitalization. We also explored the effect of incident hospitalization on subsequent incident abnormal CONUT and/or GNRI. In 4794 patients (55% women, mean age 72±8 years), 1119 (23.3%) had at least 1 abnormal score at randomization. Among the remaining 3675 patients, 1405 (38.2%) developed at least 1 abnormal score over a median follow-up of 2.9 years. Any abnormal score during follow-up was associated with a significantly higher risk of fatal and nonfatal outcomes, and all types of hospitalizations (all-cause, heart failure, and noncardiovascular hospitalizations). Among patients with normal scores at randomization, any hospitalization during follow-up was associated with a significantly higher risk of developing at least 1 abnormal score posthospitalization, compared with prehospitalization and never-hospitalized patients (adjusted hazard ratio, 1.37 [95% CI, 1.22-1.55]).

conclusionsAmong patients with heart failure with preserved ejection fraction, the rate of individuals with abnormal CONUT and/or GNRI was high, especially following a heart failure hospitalization, and was linked with excess cardiovascular and noncardiovascular events. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01920711.

Indexed as

Heart FailureMalnutritionNutritional StatusNutrition AssessmentAgedAged, 80 and overAngiotensin Receptor AntagonistsFemaleGeriatric AssessmentHospitalizationHumansMaleMiddle AgedPrognosisProspective StudiesRisk AssessmentAngiotensin Receptor Antagonistsheart failure with preserved ejection fractionmalnutritionsacubitril/valsartan

Identifiers

PMID40265602
PMCPMC12184571

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.