Prospective ARNI vs. ACE inhibitor trial to DetermIne Superiority in reducing heart failure Events after Myocardial Infarction (PARADISE‐MI): design and baseline characteristics

Jering, Karola; Claggett, Brian; Pfeffer, Marc A.; Granger, Christopher B.; Køber, Lars; Lewis, Eldrin F.; Maggioni, Aldo P.; Mann, Douglas L.; McMurray, John J.V.; Rouleau, Jean L.; Solomon, Scott D.; Steg, Philippe Gabríel; Meer, Peter van der; Wernsing, Margaret; Carter, Katherine; Guo, Weinong; Zhou, Yanguang; Lefkowitz, Martin; Gong, Jianjian; Wang, Yi; Merkely, Béla; Macı́n, Stella M.; Shah, Urmil; Nicolau, José Carlos; Braunwald, Eugene

doi:10.1002/ejhf.2191

Cited by 81 publications

(95 citation statements)

References 34 publications

(74 reference statements)

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“… 21 The PARADISE‐MI trail, aiming to ascertain whether sacubitril/valsartan prevents the development of HF and reduces cardiovascular deaths when compared with a previously proven ACEI/ARB among AMI patients, has also been recently released, although without reaching its primary endpoint. 15 In our study, it is shown that ARNI offers incremental clinical value for the prevention of cardiovascular death. The difference of our results might be because the primary endpoints of our study include the first onset as well as the recurrence of heart failure.…”

Section: Discussionmentioning

confidence: 62%

ARNI versus ACEI/ARB in Reducing Cardiovascular Outcomes after Myocardial Infarction

et al. 2021

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Aims This study aimed to compare the efficacy of angiotensin receptor‐neprilysin inhibitor (ARNI) therapy with angiotensin converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB) therapy for cardiovascular outcomes in patients with acute myocardial infarction (AMI). Methods and results Data were collected from the Biobank of the First Affiliated Hospital of Xi'an Jiaotong University between January 2016 and December 2020. A total of 7556 AMI patients were screened for eligibility. Propensity score matching based on age, sex, blood pressure, kidney function, baseline left ventricular ejection fraction (LVEF), and cardiovascular medication were conducted, resulting in 291 patients with AMI being assigned to ARNI, ACEI, and ARB group, respectively. Patients receiving ARNI had significantly lower rates of the composite cardiovascular outcome than ACEI {hazard ratio [HR] 0.51, [95% confidence interval (CI), 0.27–0.95], P = 0.02}, and ARB users [HR 0.47, (95%CI, 0.24–0.90), P = 0.02]. Patients receiving ARNI showed lower rates of cardiovascular death than ACEI [HR 0.37, (95%CI, 0.18–0.79), P = 0.01] and ARB users [HR 0.41, (95%CI, 0.18–0.95), P = 0.04]. Subgroup analysis indicated that patients with LVEF no more than 40% tend to benefit more from ARNI as compared with ACEI [HR 0.30, (95%CI, 0.11–0.86), P = 0.01] or ARB [HR 0.21, (95%CI, 0.04–1.1), P = 0.05]. Patients aged no more than 60 years exhibited reduced composite endpoints [HR for ARNI vs. ARB: 0.11, (95%CI, 0.03–0.46), P = 0.002]. Conclusions In patients with AMI, ARNI was superior to ACEI/ARB in reducing the long‐term adverse cardiovascular outcomes. Subgroup analysis further indicates that ARNI is more likely to benefit patients with LVEF less than 40% and aged less than 60 years.

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Section: Discussionmentioning

confidence: 62%

ARNI versus ACEI/ARB in Reducing Cardiovascular Outcomes after Myocardial Infarction

et al. 2021

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“…Considering that Sacubitril/ Valsartan could inhibit the activation of RAAS, many researchers hypothesized that Sacubitril/Valsartan have benefits in patients after AMI. 20,21 For these patients, there were still confusions about the benefits and risks of Sacubitril/Valsartan and ACEI. After a comprehensive search and strict screening, a total of four studies involving 6154 patients were included.…”

Section: Discussionmentioning

confidence: 99%

“…The design and baseline characteristics of the PARADISE-MI trial have been published. 21 The primary results of the PARADISE-MItrial were presented at the American College of Cardiology's 70th Annual Scientific Session, 17 but they have not been formally published in sources such as books or journals. After discussion, the PARADISE-MI trial has been considered eligible to be included in this study.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of early initiation of Sacubitril/Valsartan in patients after acute myocardial infarction: A meta‐analysis

Zhao

Zeng

Shen

2021

Clinical Cardiology

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Some randomized controlled trials have compared the effectiveness and safety outcomes between early initiation of Sacubitril/Valsartan and angiotensin-converting enzyme inhibitors (ACEIs) in patients after acute myocardial infarction. Therefore, our current meta-analysis aimed to clarify the confusion. Four Databases and relevant grey literature were searched for studies from inception to July 2, 2021. Two

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“…Sacubitril/valsartan also significantly decreased plasma NT-proBNP and reverted clinical features of cardiac remodeling (i.e., improved LVEF and cardiac volume) in HFrEF patients with and without type-2 diabetes mellitus in the PROVE-HF registry [21]. However, sacubitril/valsartan was not significantly different from valsartan alone in reverting structural remodeling in patients with asymptomatic post-myocardial infarction (MI) LV systolic dysfunction [22], although the efficacy of ARNI in this subset of patients is still being investigated in the PARADISE-MI trial [23]. Sacubitril/valsartan significantly lowered cardiovascular mortality, improved clinical outcomes (e.g., rehospitalization) and markedly reduced plasma NT-proBNP concentration, without major adverse events in acute decompensated HF, irrespective of the HF history or prior treatment with RAAS blockers [24,25].…”

Section: Heart Failurementioning

confidence: 99%

Angiotensin Receptor-Neprilysin Inhibitor (ARNI) and Cardiac Arrhythmias

Sutanto

Dobrev

Heijman

2021

IJMS

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The renin-angiotensin-aldosterone system (RAAS) plays a major role in cardiovascular health and disease. Short-term RAAS activation controls water and salt retention and causes vasoconstriction, which are beneficial for maintaining cardiac output in low blood pressure and early stage heart failure. However, prolonged RAAS activation is detrimental, leading to structural remodeling and cardiac dysfunction. Natriuretic peptides (NPs) are activated to counterbalance the effect of RAAS and sympathetic nervous system by facilitating water and salt excretion and causing vasodilation. Neprilysin is a major NP-degrading enzyme that degrades multiple vaso-modulatory substances. Although the inhibition of neprilysin alone is not sufficient to counterbalance RAAS activation in cardiovascular diseases (e.g., hypertension and heart failure), a combination of angiotensin receptor blocker and neprilysin inhibitor (ARNI) was highly effective in several clinical trials and may modulate the risk of atrial and ventricular arrhythmias. This review summarizes the possible link between ARNI and cardiac arrhythmias and discusses potential underlying mechanisms, providing novel insights about the therapeutic role and safety profile of ARNI in the cardiovascular system.

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Prospective ARNI vs. ACE inhibitor trial to DetermIne Superiority in reducing heart failure Events after Myocardial Infarction (PARADISE‐MI): design and baseline characteristics

Cited by 81 publications

References 34 publications

ARNI versus ACEI/ARB in Reducing Cardiovascular Outcomes after Myocardial Infarction

ARNI versus ACEI/ARB in Reducing Cardiovascular Outcomes after Myocardial Infarction

Efficacy and safety of early initiation of Sacubitril/Valsartan in patients after acute myocardial infarction: A meta‐analysis

Angiotensin Receptor-Neprilysin Inhibitor (ARNI) and Cardiac Arrhythmias

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