Global Differences in Heart Failure With Preserved Ejection Fraction The PARAGON-HF Trial

被引：35

作者：

Tromp, Jasper ^{[1
,2
,3
,25
]}

Claggett, Brian L. ^{[4
]}

Liu, Jiankang ^{[4
]}

Jackson, Alice M. ^{[5
]}

Jhund, Pardeep S. ^{[5
]}

Kober, Lars ^{[6
]}

Widimsky, Jiri ^{[7
]}

Boytsov, Sergey A. ^{[8
]}

Chopra, Vijay K. ^{[9
]}

Anand, Inder S. ^{[10
,11
]}

Ge, Junbo ^{[12
]}

Chen, Chen-Huan ^{[13
]}

Maggioni, Aldo P. ^{[14
]}

Martinez, Felipe ^{[15
]}

Packer, Milton ^{[16
]}

Pfeffer, Marc A. ^{[4
]}

Pieske, Burkert ^{[17
]}

Redfield, Margaret M. ^{[18
]}

Rouleau, Jean L. ^{[19
]}

Van Veldhuisen, Dirk J. ^{[3
]}

Zannad, Faiez ^{[20
,21
]}

Zile, Michael R. ^{[22
,23
]}

Rizkala, Adel R. ^{[24
]}

Inubushi-Molessa, Akiko ^{[24
]}

Lefkowitz, Martin P. ^{[24
]}

Shi, Victor C. ^{[24
]}

McMurray, John J., V ^{[5
]}

Solomon, Scott D. ^{[4
]}

Lam, Carolyn S. P. ^{[1
,2
,3
]}

机构：

[1] Natl Heart Ctr Singapore, 5 Hosp Dr, Singapore 169609, Singapore

[2] Duke NUS Med Sch, Singapore, Singapore

[3] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands

[4] Harvard Med Sch, Brigham & Womens Hosp, Cardiovasc Div, Boston, MA 02115 USA

[5] Univ Glasgow, British Heart Fdn, Inst Cardiovasc & Med Sci, Cardiovasc Res Ctr, Glasgow, Lanark, Scotland

[6] Copenhagen Univ Hosp, Rigshosp, Heart Ctr, Dept Cardiol, Copenhagen, Denmark

[7] Charles Univ Prague, Fac Med 1, Prague, Czech Republic

[8] Minist Hlth Russian Federat, Natl Res Ctr Cardiol, Moscow, Russia

[9] Heart Failure & Res Max Super Specialty Hosp Sake, New Delhi, India

[10] VA Med Ctr, Dept Med, Minneapolis, MN USA

[11] Univ Minnesota, Minneapolis, MN USA

[12] Fudan Univ, Zhongshan Hosp, Shanghai Inst Cardiovasc Dis, Shanghai, Peoples R China

[13] Natl Yang Ming Univ, Fac Med, Taipei, Taiwan

[14] Assoc Nazl Med Cardiol Osped, Florence, Italy

[15] Univ Nacl Cordoba, Cordoba, Argentina

[16] Baylor Univ, Med Ctr, Baylor Heart & Vasc Inst, Dallas, TX USA

[17] Univ Med Berlin, Dept Internal Med, Cardiol Charite, Campus Virchow Klinikum Berlin, Berlin, Germany

[18] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA

[19] Univ Montreal, Inst Cardiol Montreal, Montreal, PQ, Canada

[20] Inserm CIC 1433, Nancy, France

[21] Univ Lorraine, Ctr Hosp Reg Univ, Nancy, France

[22] Med Univ South Carolina, Charleston, SC 29425 USA

[23] Ralph H Johnson Vet Adm Med Ctr, Charleston, SC USA

[24] Novartis Pharmaceut, E Hanover, NJ USA

[25] Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Singapore, Singapore

来源：

CIRCULATION-HEART FAILURE | 2021年 / 14卷 / 04期

关键词：

atrial fibrillation; coronary artery disease; heart failure; prevalence; risk factors;

D O I：

10.1161/CIRCHEARTFAILURE.120.007901

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Heart failure with preserved ejection fraction (HFpEF) is a global public health problem with important regional differences. We investigated these differences in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF), the largest and most inclusive global HFpEF trial. Methods: We studied differences in clinical characteristics, outcomes, and treatment effects of sacubitril/valsartan in 4796 patients with HFpEF from the PARAGON-HF trial, grouped according to geographic region. Results: Regional differences in patient characteristics and comorbidities were observed: patients from Western Europe were oldest (mean 75 +/- 7 years) with the highest prevalence of atrial fibrillation/flutter (36%); Central/Eastern European patients were youngest (mean 71 +/- 8 years) with the highest prevalence of coronary artery disease (50%); North American patients had the highest prevalence of obesity (65%) and diabetes (49%); Latin American patients were younger (73 +/- 9 years) and had a high prevalence of obesity (53%); and Asia-Pacific patients had a high prevalence of diabetes (44%), despite a low prevalence of obesity (26%). Rates of the primary composite end point of total hospitalizations for HF and death from cardiovascular causes were lower in patients from Central Europe (9 per 100 patient-years) and highest in patients from North America (28 per 100 patient-years), which was primarily driven by a greater number of total hospitalizations for HF. The effect of treatment with sacubitril-valsartan was not modified by region (interaction P>0.05). Conclusions: Among patients with HFpEF recruited worldwide in PARAGON-HF, there were important regional differences in clinical characteristics and outcomes, which may have implications for the design of future clinical trials. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01920711.

引用

页码：468 / 477

页数：10

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