{"id":"b6e3f9cd21fc","type":"article","url":"https://hartvaat.nl/2020/09/29/arni-en-renale-uitkomsten-bij-hfpef-paragon-hf/","title":"ARNI en renale uitkomsten bij HFpEF: PARAGON-HF","title_en":"Angiotensin-Neprilysin Inhibition and Renal Outcomes in Heart Failure With Preserved Ejection Fraction.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"Circulation","doi":"10.1161/CIRCULATIONAHA.120.047643","source_url":"https://doi.org/10.1161/CIRCULATIONAHA.120.047643","authors":["Finnian R Mc Causland","Martin P Lefkowitz","Brian Claggett","Nagesh S Anavekar","Michele Senni","Mauro Gori","Pardeep S Jhund","Martina M McGrath","Milton Packer","Victor Shi","Dirk J Van Veldhuisen","Faiez Zannad","Josep Comin-Colet","Marc A Pfeffer","John J V McMurray","Scott D Solomon"],"significance":6,"published":"2020-09-29","source_date":"2020-09-29","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/arni-farmacologie/","https://hartvaat.nl/kennis/hartfalen/arni-sacubitril-valsartan/"],"congress":"","summary_en":"This PARAGON-HF analysis showed that sacubitril-valsartan preserves renal function better than valsartan in HFpEF patients, demonstrating renal protective effects of combined neprilysin-RAAS inhibition in preserved ejection fraction.","created":"2026-07-03T10:28:46Z","updated":"2026-07-03T13:27:55Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"PARAGON-HF analyse naar de renale uitkomsten van sacubitril/valsartan bij HFpEF.","abstract_original":"BACKGROUND: In patients with heart failure, chronic kidney disease is common and associated with a higher risk of renal events than in patients without chronic kidney disease. We assessed the renal effects of angiotensin/neprilysin inhibition in patients who have heart failure with preserved ejection fraction enrolled in the PARAGON-HF trial (Prospective Comparison of ARNI With ARB Global Outcomes in HF With Preserved Ejection Fraction). METHODS: In this randomized, double-blind, event-driven trial, we assigned 4822 patients who had heart failure with preserved ejection fraction to receive sacubitril/valsartan (n=2419) or valsartan (n=2403). Herein, we present the results of the prespecified renal composite outcome (time to first occurrence of either: ≥50% reduction in estimated glomerular filtration rate (eGFR), end-stage renal disease, or death from renal causes), the individual components of this composite, and the influence of therapy on eGFR slope. RESULTS: At randomization, eGFR was 63±19 mL·min-1·1.73 m-2. At study closure, the composite renal outcome occurred in 33 patients (1.4%) assigned to sacubitril/valsartan and 64 patients (2.7%) assigned to valsartan (hazard ratio, 0.50 [95% CI, 0.33-0.77]; P=0.001). The treatment effect on the composite renal end point did not differ according to the baseline eGFR (<60 versus ≥60 mL·min-1·1.73 m-2 (P-interaction=0.92). The decline in eGFR was less for sacubitril/valsartan than for valsartan (-2.0 [95% CI, -2.2 to -1.9] versus -2.7 [95% CI, -2.8 to -2.5] mL·min-1·1.73 m-2 per year). CONCLUSIONS: In patients with heart failure with preserved ejection fraction, sacubitril/valsartan reduced the risk of renal events, and slowed decline in eGFR, in comparison with valsartan. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01920711."}