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[PMID]:29286056
[Au] Autor:Zaid Iskandar M; Lang CC
[Ad] Endereço:Ninewells Hospital and Medical School, Dundee, Scotland, UK.
[Ti] Título:Sacubitril and valsartan fixed combination to reduce heart failure events in post-acute myocardial infarction patients.
[So] Source:Drugs Today (Barc);53(10):545-551, 2017 Oct.
[Is] ISSN:1699-3993
[Cp] País de publicação:Spain
[La] Idioma:eng
[Ab] Resumo:Heart failure is a term used to define a constellation of symptoms and signs that are commonly attributed to the inability of the heart to produce a cardiac output that meets the demands of the body. It remains a deadly disease, affecting between 1-2% of the population, and is more common in the elderly, with around 6-10% of patients over 65 suffering from the condition. Sacubitril/valsartan (LCZ-696) is a combined neprilysin inhibitor and angiotensin AT1 receptor blocker approved in recent years for the treatment of chronic heart failure with reduced ejection fraction. In an area where there have been limited pharmacological advances in the last 10 years, this drug was a game changer and a much welcomed addition to contemporary heart failure therapy. It is currently being studied in patients with heart failure with preserved ejection fraction and for the reduction of heart failure events post-acute myocardial infarction. Results from the ongoing PARADISE-MI study are awaited by the global cardiology community with great interest.
[Mh] Termos MeSH primário: Aminobutiratos/administração & dosagem
Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem
Insuficiência Cardíaca/tratamento farmacológico
Infarto do Miocárdio/complicações
Neprilisina/antagonistas & inibidores
Tetrazóis/administração & dosagem
Valsartana/administração & dosagem
[Mh] Termos MeSH secundário: Aminobutiratos/farmacologia
Ensaios Clínicos como Assunto
Seres Humanos
Tetrazóis/farmacologia
Valsartana/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (Angiotensin II Type 1 Receptor Blockers); 0 (LCZ 696); 0 (Tetrazoles); 80M03YXJ7I (Valsartan); EC 3.4.24.11 (Neprilysin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE
[do] DOI:10.1358/dot.2017.53.10.2722396


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[PMID]:29180454
[Au] Autor:Engeli S; Stinkens R; Heise T; May M; Goossens GH; Blaak EE; Havekes B; Jax T; Albrecht D; Pal P; Tegtbur U; Haufe S; Langenickel TH; Jordan J
[Ad] Endereço:From the Institute of Clinical Pharmacology (S.E., M.M., S.H., J.J.), Institute of Sports Medicine (U.T.), Hannover Medical School, Germany; Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism (R.S., G.H.G., E.E.B.), Division of Endocrinology, Department
[Ti] Título:Effect of Sacubitril/Valsartan on Exercise-Induced Lipid Metabolism in Patients With Obesity and Hypertension.
[So] Source:Hypertension;71(1):70-77, 2018 01.
[Is] ISSN:1524-4563
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sacubitril/valsartan (LCZ696), a novel angiotensin receptor-neprilysin inhibitor, was recently approved for the treatment of heart failure with reduced ejection fraction. Neprilysin degrades several peptides that modulate lipid metabolism, including natriuretic peptides. In this study, we investigated the effects of 8 weeks' treatment with sacubitril/valsartan on whole-body and adipose tissue lipolysis and lipid oxidation during defined physical exercise compared with the metabolically neutral comparator amlodipine. This was a multicenter, randomized, double-blind, active-controlled, parallel-group study enrolling subjects with abdominal obesity and moderate hypertension (mean sitting systolic blood pressure ≥130-180 mm Hg). Lipolysis during rest and exercise was assessed by microdialysis and [1,1,2,3,3- H]-glycerol tracer kinetics. Energy expenditure and substrate oxidation were measured simultaneously using indirect calorimetry. Plasma nonesterified fatty acids, glycerol, insulin, glucose, adrenaline and noradrenaline concentrations, blood pressure, and heart rate were also determined. Exercise elevated plasma glycerol, free fatty acids, and interstitial glycerol concentrations and increased the rate of glycerol appearance. However, exercise-induced stimulation of lipolysis was not augmented on sacubitril/valsartan treatment compared with amlodipine treatment. Furthermore, sacubitril/valsartan did not alter energy expenditure and substrate oxidation during exercise compared with amlodipine treatment. In conclusion, sacubitril/valsartan treatment for 8 weeks did not elicit clinically relevant changes in exercise-induced lipolysis or substrate oxidation in obese patients with hypertension, implying that its beneficial cardiovascular effects cannot be explained by changes in lipid metabolism during exercise. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01631864.
[Mh] Termos MeSH primário: Aminobutiratos
Anlodipino/administração & dosagem
Exercício/fisiologia
Hipertensão
Neprilisina
Obesidade Abdominal
Tetrazóis
[Mh] Termos MeSH secundário: Tecido Adiposo/metabolismo
Aminobutiratos/administração & dosagem
Aminobutiratos/efeitos adversos
Aminobutiratos/farmacocinética
Antagonistas de Receptores de Angiotensina/administração & dosagem
Antagonistas de Receptores de Angiotensina/efeitos adversos
Antagonistas de Receptores de Angiotensina/farmacocinética
Pressão Sanguínea/efeitos dos fármacos
Bloqueadores dos Canais de Cálcio/administração & dosagem
Método Duplo-Cego
Monitoramento de Medicamentos/métodos
Feminino
Seres Humanos
Hipertensão/diagnóstico
Hipertensão/tratamento farmacológico
Hipertensão/metabolismo
Metabolismo dos Lipídeos/efeitos dos fármacos
Metabolismo dos Lipídeos/fisiologia
Masculino
Meia-Idade
Peptídeos Natriuréticos/metabolismo
Neprilisina/antagonistas & inibidores
Neprilisina/metabolismo
Obesidade Abdominal/diagnóstico
Obesidade Abdominal/tratamento farmacológico
Obesidade Abdominal/metabolismo
Tetrazóis/administração & dosagem
Tetrazóis/efeitos adversos
Tetrazóis/farmacocinética
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (Angiotensin Receptor Antagonists); 0 (Calcium Channel Blockers); 0 (LCZ 696); 0 (Natriuretic Peptides); 0 (Tetrazoles); 1J444QC288 (Amlodipine); EC 3.4.24.11 (Neprilysin)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1161/HYPERTENSIONAHA.117.10224


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[PMID]:29241885
[Au] Autor:Ramos IC; Versteegh MM; de Boer RA; Koenders JMA; Linssen GCM; Meeder JG; Rutten-van Mölken MPMH
[Ad] Endereço:Institute for Medical Technology Assessment, Erasmus University Rotterdam, the Netherlands. Electronic address: corroramos@imta.eur.nl.
[Ti] Título:Cost Effectiveness of the Angiotensin Receptor Neprilysin Inhibitor Sacubitril/Valsartan for Patients with Chronic Heart Failure and Reduced Ejection Fraction in the Netherlands: A Country Adaptation Analysis Under the Former and Current Dutch Pharmacoeconomic Guidelines.
[So] Source:Value Health;20(10):1260-1269, 2017 12.
[Is] ISSN:1524-4733
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To describe the adaptation of a global health economic model to determine whether treatment with the angiotensin receptor neprilysin inhibitor LCZ696 is cost effective compared with the angiotensin-converting enzyme inhibitor enalapril in adult patients with chronic heart failure with reduced left ventricular ejection fraction in the Netherlands; and to explore the effect of performing the cost-effectiveness analyses according to the new pharmacoeconomic Dutch guidelines (updated during the submission process of LCZ696), which require a value-of-information analysis and the inclusion of indirect medical costs of life-years gained. METHODS: We adapted a UK model to reflect the societal perspective in the Netherlands by including travel expenses, productivity loss, informal care costs, and indirect medical costs during the life-years gained and performed a preliminary value-of-information analysis. RESULTS: The incremental cost-effectiveness ratio obtained was €17,600 per quality-adjusted life-year (QALY) gained. This was robust to changes in most structural assumptions and across different subgroups of patients. Probability sensitivity analysis results showed that the probability that LCZ696 is cost-effective at a €50,000 per QALY threshold is 99.8%, with a population expected value of perfect information of €297,128. On including indirect medical costs of life-years gained, the incremental cost-effectiveness ratio was €26,491 per QALY gained, and LCZ696 was 99.46% cost effective at €50,000 per QALY, with a population expected value of perfect information of €2,849,647. CONCLUSIONS: LCZ696 is cost effective compared with enalapril under the former and current Dutch guidelines. However, the (monetary) consequences of making a wrong decision were considerably different in both scenarios.
[Mh] Termos MeSH primário: Aminobutiratos/uso terapêutico
Antagonistas de Receptores de Angiotensina/uso terapêutico
Farmacoeconomia
Insuficiência Cardíaca/tratamento farmacológico
Modelos Econômicos
Tetrazóis/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Aminobutiratos/economia
Antagonistas de Receptores de Angiotensina/economia
Inibidores da Enzima Conversora de Angiotensina/economia
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico
Doença Crônica
Análise Custo-Benefício
Enalapril/economia
Enalapril/uso terapêutico
Feminino
Guias como Assunto
Insuficiência Cardíaca/economia
Seres Humanos
Masculino
Meia-Idade
Neprilisina/antagonistas & inibidores
Países Baixos
Anos de Vida Ajustados por Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Volume Sistólico/efeitos dos fármacos
Tetrazóis/economia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (Angiotensin Receptor Antagonists); 0 (Angiotensin-Converting Enzyme Inhibitors); 0 (LCZ 696); 0 (Tetrazoles); 69PN84IO1A (Enalapril); EC 3.4.24.11 (Neprilysin)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:27771391
[Au] Autor:Vemula H; Kitase Y; Ayon NJ; Bonewald L; Gutheil WG
[Ad] Endereço:Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO 64108, USA.
[Ti] Título:Gaussian and linear deconvolution of LC-MS/MS chromatograms of the eight aminobutyric acid isomers.
[So] Source:Anal Biochem;516:75-85, 2017 Jan 01.
[Is] ISSN:1096-0309
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Isomeric molecules present a challenge for analytical resolution and quantification, even with MS-based detection. The eight aminobutyric acid (ABA) isomers are of interest for their various biological activities, particularly γ-aminobutyric acid (GABA) and the d- and l-isomers of ß-aminoisobutyric acid (ß-AIBA; BAIBA). This study aimed to investigate LC-MS/MS-based resolution of these ABA isomers as their Marfey's (Mar) reagent derivatives. HPLC was able to separate three Mar-ABA isomers l-ß-ABA (l-BABA), and l- and d-α-ABA (AABA) completely, with three isomers (GABA, and d/l-BAIBA) in one chromatographic cluster, and two isomers (α-AIBA (AAIBA) and d-BABA) in a second cluster. Partially separated cluster components were deconvoluted using Gaussian peak fitting except for GABA and d-BAIBA. MS/MS detection of Marfey's derivatized ABA isomers provided six MS/MS fragments, with substantially different intensity profiles between structural isomers. This allowed linear deconvolution of ABA isomer peaks. Combining HPLC separation with linear and Gaussian deconvolution allowed resolution of all eight ABA isomers. Application to human serum found a substantial level of l-AABA (13 µM), an intermediate level of l-BAIBA (0.8 µM), and low but detectable levels (<0.2 µM) of GABA, l-BABA, AAIBA, d-BAIBA, and d-AABA. This approach should be useful for LC-MS/MS deconvolution of other challenging groups of isomeric molecules.
[Mh] Termos MeSH primário: Aminobutiratos/sangue
Espectrometria de Massas/métodos
[Mh] Termos MeSH secundário: Cromatografia Líquida/métodos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Aminobutyrates)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161106
[St] Status:MEDLINE


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[PMID]:28460381
[Au] Autor:Vitting KE
[Ad] Endereço:From Suburban Nephrology Group, Wayne, New Jersey.
[Ti] Título:Sacubitril-Valsartan in Heart Failure.
[So] Source:Ann Intern Med;166(9):680, 2017 05 02.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aminobutiratos
Tetrazóis
[Mh] Termos MeSH secundário: Insuficiência Cardíaca
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (LCZ 696); 0 (Tetrazoles)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.7326/L17-0049


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[PMID]:28460380
[Au] Autor:Werner BE
[Ad] Endereço:From Cleveland Clinic Foundation, Cleveland, Ohio.
[Ti] Título:Sacubitril-Valsartan in Heart Failure.
[So] Source:Ann Intern Med;166(9):680-681, 2017 05 02.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aminobutiratos
Tetrazóis
[Mh] Termos MeSH secundário: Insuficiência Cardíaca
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (LCZ 696); 0 (Tetrazoles)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.7326/L17-0048


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[PMID]:28460379
[Au] Autor:Spellberg B
[Ad] Endereço:From LAC+USC Medical Center and Keck School of Medicine at USC, Los Angeles, California.
[Ti] Título:Sacubitril-Valsartan in Heart Failure.
[So] Source:Ann Intern Med;166(9):680, 2017 05 02.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aminobutiratos
Tetrazóis
[Mh] Termos MeSH secundário: Insuficiência Cardíaca
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (LCZ 696); 0 (Tetrazoles)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.7326/L17-0047


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[PMID]:28460378
[Au] Autor:Packer M; Armstrong WM; Rothstein JM; Emmett M
[Ad] Endereço:From Baylor Heart and Vascular Institute and Baylor University Medical Center, Dallas, Texas.
[Ti] Título:Sacubitril-Valsartan in Heart Failure.
[So] Source:Ann Intern Med;166(9):681-682, 2017 05 02.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aminobutiratos
Tetrazóis
[Mh] Termos MeSH secundário: Insuficiência Cardíaca
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (LCZ 696); 0 (Tetrazoles)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.7326/L17-0046


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[PMID]:29050562
[Au] Autor:Polhemus DJ; Trivedi RK; Gao J; Li Z; Scarborough AL; Goodchild TT; Varner KJ; Xia H; Smart FW; Kapusta DR; Lefer DJ
[Ad] Endereço:Cardiovascular Center of Excellence, Louisiana State University (LSU) Health Sciences Center, New Orleans, Louisiana; Department of Pharmacology and Experimental Therapeutics, LSU Health Sciences Center, New Orleans, Louisiana.
[Ti] Título:Renal Sympathetic Denervation Protects the Failing Heart Via Inhibition of Neprilysin Activity in the Kidney.
[So] Source:J Am Coll Cardiol;70(17):2139-2153, 2017 Oct 24.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sustained sympathetic activation contributes to the progression of myocardial cell injury, cardiac fibrosis, and left ventricular (LV) dysfunction in heart failure (HF). OBJECTIVES: This study investigated the effects of radiofrequency renal nerve denervation (RF-RDN) on the pathobiology of HF and the interaction between the renal sympathetic nerves and natriuretic peptide (NP) metabolism. METHODS: Spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY) were subjected to 45 min of coronary artery ligation and reperfusion for 12 weeks. At 4 weeks post-reperfusion, SHR and WKY underwent either bilateral RF-RDN or sham-RDN. RESULTS: Following RF-RDN in both strains, LV ejection fraction remained significantly above those levels in respective sham-RDN rats, and at the end of the 12-week study, rats in both strains had significantly reduced LV fibrosis and improved vascular function. RF-RDN therapy significantly improved vascular reactivity to endothelium-dependent and -independent vasodilators as well as vascular compliance in the setting of severe HF. Improvements in LV function were accompanied by significant elevations in circulating NP as compared to those associated with sham-RDN. Further investigation into the cause of increased circulating NP levels demonstrated that RF-RDN significantly inhibited renal neprilysin activity in SHR and WKY with HF. Likewise, chronic treatment with the beta antagonist bisoprolol inhibited renal neprilysin activity and increased circulation NP levels in WKY with HF. CONCLUSIONS: This study identifies a novel endogenous pathway by which the renal nerves participate in the degradation of cardioprotective NP. Furthermore, removal of the influence of the renal nerves on kidney function attenuates renal neprilysin activity, augments circulating NP levels, reduces myocardial fibrosis, and improves LV function in the setting of HF.
[Mh] Termos MeSH primário: Insuficiência Cardíaca/terapia
Rim/inervação
Neprilisina/antagonistas & inibidores
Simpatectomia
[Mh] Termos MeSH secundário: Aminobutiratos/farmacologia
Angiotensina II/sangue
Animais
Bisoprolol/farmacologia
Pressão Sanguínea
Ecocardiografia
Miocárdio/química
Miocárdio/patologia
Neprilisina/fisiologia
Nitritos/análise
Norepinefrina/sangue
Ratos
Ratos Endogâmicos SHR
Ratos Endogâmicos WKY
Artéria Renal/inervação
Renina/sangue
Traumatismo por Reperfusão/fisiopatologia
Tetrazóis/farmacologia
Função Ventricular Esquerda/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (LCZ 696); 0 (Nitrites); 0 (Tetrazoles); 11128-99-7 (Angiotensin II); EC 3.4.23.15 (Renin); EC 3.4.24.11 (Neprilysin); X4W3ENH1CV (Norepinephrine); Y41JS2NL6U (Bisoprolol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171021
[St] Status:MEDLINE


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[PMID]:29018174
[Au] Autor:Kristensen SL; Jhund PS; Mogensen UM; Rørth R; Abraham WT; Desai A; Dickstein K; Rouleau JL; Zile MR; Swedberg K; Packer M; Solomon SD; Køber L; McMurray JJV; PARADIGM-HF and ATMOSPHERE Committees and Investigators
[Ad] Endereço:From the BHF Cardiovascular Research Centre, University of Glasgow, United Kingdom (S.L.K., P.S.J., U.M.M., R.R., J.J.V.M.); Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark (S.L.K., U.M.M., R.R., L.K.); The Division of Cardiovascular Medicine, Davis Heart and Lung R
[Ti] Título:Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide Levels in Heart Failure Patients With and Without Atrial Fibrillation.
[So] Source:Circ Heart Fail;10(10), 2017 Oct.
[Is] ISSN:1941-3297
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients with heart failure (HF) and atrial fibrillation (AF) have higher circulating levels of NT-proBNP (N-terminal pro-B-type natriuretic peptide) than HF patients without AF. There is uncertainty about the prognostic importance of a given concentration of NT-proBNP in HF patients with and without AF. We investigated this question in a large cohort of patients with HF and reduced ejection fraction. METHODS AND RESULTS: We studied 14 737 patients with HF and reduced ejection fraction and a measurement of NT-proBNP at time of screening, enrolled in either the PARADIGM-HF trial (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) or the ATMOSPHERE trial (Aliskiren Trial to Minimize Outcomes in Patients With Heart Failure), of whom 3575 (24%) had AF on their baseline ECG. Median (Q1, Q3) levels of NT-proBNP were 1817 pg/mL (1095-3266 pg/mL) in those with AF and 1271 pg/mL (703-2569 pg/mL) in those without ( <0.0001). Patients with AF were older (67 versus 62 years), had worse New York Heart Association class (III/IV; 36% versus 24%), and experienced fewer previous HF hospitalizations (52% versus 61%) or myocardial infarction (30% versus 46%); all <0.001. We categorized patients with and without AF into 5 NT-proBNP bands: <400, 400 to 999 (reference), 1000 to 1999, 2000 to 2999, and ≥3000 pg/mL. For the primary composite outcome of cardiovascular death or HF hospitalization, event rates differed for patients with and without AF in the lowest band (<400 pg/mL; 8.2 versus 5.0 per 100 patient-years), but not for the higher bands (400-999 pg/mL, 7.4 versus 7.7 per 100 patient-years; 1000-1999 pg/mL, 9.8 versus 11.4 per 100 patient-year; 2000-2999 pg/mL, 13.5 versus 13.4 per 100 patient-years; ≥3000 pg/mL, 22.7 versus 23.0 per 100 patient-years). These findings were consistent whether NT-proBNP was examined as a categorical or continuous variable and before and after adjustment for other prognostic variables. We found similar results for the components of the composite outcome and all-cause mortality. CONCLUSIONS: HF and reduced ejection fraction patients with AF had higher NT-proBNP than those without AF. However, above a concentration of 400 pg/mL (representing most patients in each group), NT-proBNP had similar predictive value for adverse cardiovascular outcomes, irrespective of AF status. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier NCT00853658 (ATMOSPHERE) and NCT01035255 (PARADIGM-HF).
[Mh] Termos MeSH primário: Fibrilação Atrial/sangue
Doenças Cardiovasculares/mortalidade
Insuficiência Cardíaca/sangue
Hospitalização/estatística & dados numéricos
Peptídeo Natriurético Encefálico/sangue
Fragmentos de Peptídeos/sangue
[Mh] Termos MeSH secundário: Idoso
Amidas/uso terapêutico
Aminobutiratos/uso terapêutico
Antagonistas de Receptores de Angiotensina/uso terapêutico
Anti-Hipertensivos/uso terapêutico
Fibrilação Atrial/complicações
Estudos de Casos e Controles
Estudos de Coortes
Enalapril/uso terapêutico
Feminino
Fumaratos/uso terapêutico
Insuficiência Cardíaca/complicações
Insuficiência Cardíaca/tratamento farmacológico
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Volume Sistólico
Tetrazóis/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amides); 0 (Aminobutyrates); 0 (Angiotensin Receptor Antagonists); 0 (Antihypertensive Agents); 0 (Fumarates); 0 (LCZ 696); 0 (Peptide Fragments); 0 (Tetrazoles); 0 (pro-brain natriuretic peptide (1-76)); 114471-18-0 (Natriuretic Peptide, Brain); 502FWN4Q32 (aliskiren); 69PN84IO1A (Enalapril)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE



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