Evidence map›Paper›PMID 40839760›Full record

Trial reportEuropean heart journal. Cardiovascular pharmacotherapy2025

Sacubitril/valsartan and quality of life assessed using the EuroQol Five-dimension Three-level questionnaire level sum score (EQ-5D-3L-LSS) in patients with HFrEF and HFmrEF/HFpEF.

Mingming Yang, Alasdair D Henderson, Inder S Anand, Akshay S Desai, Carolyn S P Lam, Aldo P Maggioni, Felipe A Martinez, Jean L Rouleau, Karl Swedberg, Muthiah Vaduganathan and 9 more

2 registry-linked trialsAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in European heart journal. Cardiovascular pharmacotherapy, 2025. 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. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT01035255 phase3terminatednot on this map

A Multicenter, Randomized, Double-blind, Parallel Group, Active-controlled Study to Evaluate the Efficacy and Safety of LCZ696 Compared to Enalapril on Morbidity and Mortality in Patients With Chronic Heart Failure and Reduced Ejection Fraction

TypeinterventionalSponsorNovartis PharmaceuticalsRan2009 to 2014Enrolled8,442ConditionsHeart Failure With Reduced Ejection FractionArmsLCZ696 200 mg BID, Enalapril 10 mg BID
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

19 authors.

Mingming YangBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
Alasdair D HendersonBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
Inder S AnandDepartment of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN 55455, USA.ORCID 0000-0003-1308-4963
Akshay S DesaiCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Carolyn S P LamNational Heart Centre Singapore & Duke-National University of Singapore  169609, Singapore.ORCID 0000-0003-1903-0018
Aldo P MaggioniANMCO Research Center, Heart Care Foundation, Florence 50121, Italy.
Felipe A MartinezUniversidad Nacional de Córdoba, Córdoba X5000, Argentina.
Jean L RouleauInstitut de Cardiologie de Montréal, Université de Montréal, Montréal H1T 1C8, Canada.
Karl SwedbergDepartment of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg 40530, Sweden.
Muthiah VaduganathanCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.ORCID 0000-0003-0885-1953
Dirk J van VeldhuisenDepartment of Cardiology, Thorax Center, University Medical Center, Postbus 30.001, 9700 RB Groningen, the Netherlands.
Faiez ZannadInserm Clinical Investigation Centre, CHU, Université de Lorraine, Nancy 54500, France.ORCID 0000-0001-7456-1570
Michael R ZileRHJ Department of Veterans Affairs Medical Center, Medical University of South Carolina, Charleston, SC 29401, USA.
Milton PackerBaylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX 75226, USA.ORCID 0000-0003-1828-2387
Adel RizkalaNovartis Pharmaceuticals Corporation, East Hanover, NJ 07936, USA.
Eldrin F LewisDivision of Cardiovascular Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA 94305, USA.
Pardeep S JhundBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
Scott D SolomonCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
John J V McMurrayBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.ORCID 0000-0002-6317-3975

Funding

British Heart Foundation Centre of Research Excellence RE/18/6/34217NovartisPARADIGM-HFPARAGON-HFVera Melrose Heart Failure Research Fund
6 · The paper itself

Abstract

aimsTo investigate the EQ-5D-3L Level Sum Score (LSS) in patients with heart failure (HF) and reduced (HFrEF) and mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) and the effect of sacubitril/valsartan on this score using patient-level data from the PARADIGM-HF and PARAGON-HF trials. METHODS AND

resultsThe LSS was calculated by summing the three levels (1-3) for each of the five domains (minimum sum score = 5; maximum sum score = 15). Patient characteristics and outcomes were compared across LSS tertiles (T1-T3) at baseline. Cox models were used to evaluate the primary endpoint [first HF hospitalization or cardiovascular death (CVD)] according to tertiles of LSS. Changes in LSS severity at 8 months were analysed using ordinal logistic regression models to estimate the effect of sacubitril/valsartan vs. enalapril or valsartan. Of 13 195 patients, 12 974 had a baseline LSS. Compared to lower LSS, patients with higher (worse) scores were older, more often women and White, and had more comorbidities and more severe HF. At 8 months, patients assigned to sacubitril/valsartan experienced more improvement and less worsening of LSS vs. the comparator: OR:1.16 (95%CI: 1.08-1.24). Sacubitril/valsartan also reduced the risk of the primary outcome across LSS tertiles: T1: HR: 0.87 (95%CI: 0.75-1.00); T2: 0.80 (95%CI: 0.71-0.90); T3: 0.87 (95%CI: 0.77-0.97); Pinteraction = 0.59. Higher LSS was independently associated with a greater risk of the primary endpoint, and the achieved LSS at 8 months may be more strongly associated with subsequent outcomes.

conclusionSacubitril/valsartan significantly reduced the risk of HF events and improved health status across the LSS spectrum in HFrEF and HFmrEF/HFpEF. CLINICAL

trial registrationhttps://www.clinicaltrials.gov. Unique identifiers: NCT01920711 (PARAGON-HF), NCT01035255 (PARADIGM-HF).

Indexed as

AminobutyratesAngiotensin II Type 1 Receptor BlockersAngiotensin Receptor AntagonistsHeart FailureProtease InhibitorsQuality of LifeStroke VolumeAgedBiphenyl CompoundsDrug CombinationsFemaleHumansMaleMiddle AgedNeprilysinRecovery of FunctionAminobutyratesAngiotensin II Type 1 Receptor BlockersAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug CombinationsNeprilysinProtease Inhibitorssacubitril and valsartan sodium hydrate drug combinationTetrazolesValsartanEQ-5D-3LHeart failureQuality of lifeSacubitril/valsartanSymptoms

Identifiers

PMID40839760
PMCPMC12582660

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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.