Is Sacubitril/Valsartan Helpful for Women with Heart Failure and Preserved Ejection Fraction?

Despite a signal of benefit from this subanalysis of PARAGON-HF, the study's overall negative findings should prevail in treatment decisions.

Given the marked female preponderance among individuals with heart failure and preserved ejection fraction (HFpEF), the absence of proven therapies for the syndrome disproportionately affects women. To compare outcomes between women and men, researchers performed a subgroup analysis of the manufacturer-sponsored PARAGON-HF (NEJM JW Cardiol Oct 2019 and N Engl J Med 2019; 381:1609), which showed no significant impact of angiotensin receptor–neprilysin inhibition with sacubitril/valsartan over valsartan alone on outcomes in almost 5000 enrollees with HFpEF (left ventricular EF, ≥45%; 52% women).

On average, compared with the men in the trial, the women were older (71.8 vs. 73.6) and had lower natriuretic peptide levels, lower estimated glomeru…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)