The Register Citizen (Torrington, CT)
Study: Drug improves acute heart failure treatment
NEW HAVEN — A drug used to treat chronic heart failure may also be more effective in treating the acute form of the disease than the medication currently given, according to a Yale School of Medicine study.
The standard treatment for acute heart failure has been enalapril, sold as Vasotec, an ACE inhibitor that relaxes blood vessels and so reduces blood pressure, and it is also used to treat hypertension.
Patients with chronic heart failure, a less serious disease, have been treated with sacubitril/valsartan, according to a news release. Researchers tested sacubitril/valsartan, marketed as Entresto among other brands, on 800 patients at 129 sites with acute heart failure to see how the two compared, according to the release. Acute heart failure is the No. 1 cause of hospitalization among older adults, the release said. The randomized, double-blind trial was called PIONEER-HF.
The study found that in the patients with acute heart failure who took sacubitril/ valsartan a measure of severity, known as NTproBNP, reduced faster than among those on enalapril, as quickly as one week into the study, according to the release.
“It worked to reduce NTproBNP rapidly and to a greater extent than enalapril,” said Dr. Eric Velazquez, corresponding author, professor of cardiology at Yale School of Medicine and a principal investigator in the PIONEER-HF study, in the release. “There were multiple markers including troponin T, a marker of heart cell injury, that suggested substantial improvement.”
The two medications had similar safety outcomes, including effects on kidney function and blood pressure, the release said.
“The results of this landmark study should help inform our basic approach to treating hospitalized patients with acute heart failure,” Velazquez said in the release. “Once acute heart failure is diagnosed, patients are stabilized, and a low ejection fraction is confirmed, sacubitril/valsartan should be started promptly to reduce NT-proBNP and reduce the risk of post-discharge heart failure hospitalization.”
A previous clinical trial, PARADIGM-HF, had shown sacubitril/valsartan’s effectiveness in treating chronic heart failure. “There are consistent results from both trials,” Velazquez said. “It is safe and there’s a rapid outcome. If it becomes the standard, we are likely to reduce the risk of hospitalization for heart failure, and that will have a positive clinical impact and societal impact.”
The study was published in the New England Journal of Medicine and presented at the American Heart Association Scientific Sessions in Chicago Sunday.