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DOI: 10.1055/s-0034-1391741
PARADIGM-HF-Studie
Müssen die Leitlinien zur medikamentösen Behandlung der chronischen Herzinsuffizienz jetzt umgeschrieben werden?Publikationsverlauf
Publikationsdatum:
08. April 2015 (online)
![](https://www.thieme-connect.de/media/kardiologie-u2d/201501/lookinside/thumbnails/10.1055-s-0034-1391741-1.jpg)
Abstract
The PARADIGM-HF study is so far the largest study in heart failure, which included more than 8000 patients with symptomatic HFrEF. Due to superiority of the combined angiotensin receptor-neprilysin-inhibitor LCZ696 the PARADIGM-HF study was terminated early after a median follow-up of 27 months. Compared to „standard therapy“ with high-dose enalapril (10 mg bid) LCZ696 (200 mg bid, consisting of 160 mg valsartan plus 40 mg sacubitril) not only reduced the primary endpoint of death from cardiovascular causes and hospitalization for heart failure by 20 %, but also death from any cause by 16 %. The overall tolerability of LCZ696 was better than that of enalapril. Serious angioedema were not oberserved. LCZ696 increases plasma levels of BNP by inhibiting its degradation. Therefore, the plasma levels of NT-proBNP appear to be better suited for follow-up of heart failure patients treated with LCZ696. Due to the remarkable results of PARADIGM-HF study LCZ696 appears to soon replace ACE-inhibitors as standard therapy in symptomatic HFrEF and the guidelines for treatment of heart failure are required to be updated.
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