{"id":"0dbe4960e2cd","type":"article","url":"https://hartvaat.nl/2022/06/14/omecamtiv-mecarbil-bij-hartfalen-met-en-zonder-atriumfibrilleren-galactic-hf/","title":"Omecamtiv mecarbil bij hartfalen met en zonder atriumfibrilleren: GALACTIC-HF","title_en":"Influence of atrial fibrillation on efficacy and safety of omecamtiv mecarbil in heart failure: the GALACTIC-HF trial.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog"],"tags":["aficamten","hfref"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehac144","source_url":"https://doi.org/10.1093/eurheartj/ehac144","authors":["Scott D Solomon","Brian L Claggett","Zi Michael Miao","Rafael Diaz","G Michael Felker","John J V McMurray","Marco Metra","Ramon Corbalan","Gerasimos Filippatos","Assen R Goudev","Viatcheslav Mareev","Pranas Serpytis","Thomas Suter","Mehmet B Yilmaz","Faiez Zannad","Stuart Kupfer","Stephen B Heitner","Fady I Malik","John R Teerlink"],"significance":6,"published":"2022-06-14","source_date":"2022-06-14","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/digoxine-bij-hartfalen/","https://hartvaat.nl/kennis/hartfalen/ivabradine-bij-hartfalen/"],"congress":"","summary_en":"This GALACTIC-HF subanalysis confirmed that omecamtiv mecarbil is equally effective in HFrEF patients with and without atrial fibrillation, supporting cardiac myosin activation regardless of rhythm status.","created":"2026-07-03T10:29:48Z","updated":"2026-07-03T13:28:55Z","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":"Subanalyse van GALACTIC-HF toonde dat omecamtiv mecarbil even effectief was bij HFrEF-patiënten met als zonder atriumfibrilleren. De cardiale myosine-activator verminderde hartfalengebeurtenissen ongeacht het ritme, wat de brede toepasbaarheid bevestigt.","abstract_original":"AIMS: In GALACTIC-HF, the cardiac myosin activator omecamtiv mecarbil compared with placebo reduced the risk of heart failure events or cardiovascular death in patients with heart failure with reduced ejection fraction. We explored the influence of atrial fibrillation or flutter (AFF) on the effectiveness of omecamtiv mecarbil. METHODS AND RESULTS: GALACTIC-HF enrolled patients with New York Heart Association (NYHA) Class II-IV heart failure, left ventricular ejection fraction ≤35%, and elevated natriuretic peptides. We assessed whether the presence or absence of AFF, a pre-specified subgroup, modified the treatment effect for the primary and secondary outcomes, and additionally explored effect modification in patients who were or were not receiving digoxin. Patients with AFF (n = 2245, 27%) were older, more likely to be randomized as an inpatient, less likely to have a history of ischaemic aetiology or myocardial infarction, had a worse NYHA class, worse quality of life, lower estimated glomerular filtration rate, and higher N-terminal pro-B-type natriuretic peptide. The treatment effect of omecamtiv mecarbil was modified by baseline AFF (interaction P = 0.012), with patients without AFF at baseline deriving greater benefit. The worsening of the treatment effect by baseline AFF was significantly more pronounced in digoxin users than in non-users (interaction P = 0.007); there was minimal evidence of effect modification in those patients not using digoxin (P = 0.47) or in digoxin users not in AFF. CONCLUSION: Patients in AFF at baseline were less likely to benefit from omecamtiv mecarbil than patients without AFF, although the attenuation of the treatment effect was disproportionally concentrated in patients with AFF who were also receiving digoxin.Clinical Trial Registration: NCT02929329."}