Baseline Characteristics of Patients With Heart Failure and Preserved Ejection Fraction in the PARAGON-HF Trial
Authors: Solomon Scott D. , Rizkala Adel R. , Lefkowitz Martin P. , Shi Victor C. , Gong JianJian , Anavekar Nagesh , Anker Stefan D. , Arango Juan L. , Arenas Jose L. , Atar Dan , Ben-Gal Turia , Boytsov Sergey A. , Chen Chen-Huan , Chopra Vijay K. , Cleland John , Comin-Colet Josep , Duengen Hans-Dirk , Echeverría Luis Eduardo , Filippatos Gerasimos , Flammer Andreas J. , Galinier Michel , Godoy Armando , Goncalvesova Eva , Janssens Stefan , Katova Tzvetana , Køber Lars , Lelonek Małgorzata , Linssen Gerard , Lund Lars H. , O’Meara Eileen , Merkely Béla , Milicic Davor , Oh Byung-Hee , Perrone Sergio V. , Ranjith Naresh , Saito Yoshihiko , Saraiva Jose F. , Shah Sanjiv , Seferovic Petar M. , Senni Michele , Sibulo Antonio S. , Sim David , Sweitzer Nancy K. , Taurio Jyrki , Vinereanu Dragos , Vrtovec Bojan , Widimský Jiří , Yilmaz Mehmet B. , Zhou Jingmin , Zweiker Robert , Anand Inder S. , Ge Junbo , Lam Carolyn S.P. , Maggioni Aldo P. , Martinez Felipe , Packer Milton , Pfeffer Marc A. , Pieske Burkert , Redfield Margaret M. , Rouleau Jean L. , Van Veldhuisen Dirk J. , Zannad Faiez , Zile Michael R. , McMurray John J.V. 
Published: July 2018

Background:
To describe the baseline characteristics of patients with heart failure and preserved left ventricular ejection fraction enrolled in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF) comparing sacubitril/valsartan to valsartan in reducing morbidity and mortality.

Methods and Results:
We report key demographic, clinical, and laboratory findings, and baseline therapies, of 4822 patients randomized in PARAGON-HF, grouped by factors that influence criteria for study inclusion. We further compared baseline characteristics of patients enrolled in PARAGON-HF with those patients enrolled in other recent trials of heart failure with preserved ejection fraction (HFpEF). Among patients enrolled from various regions (16% Asia-Pacific, 37% Central Europe, 7% Latin America, 12% North America, 28% Western Europe), the mean age of patients enrolled in PARAGON-HF was 72.7±8.4 years, 52% of patients were female, and mean left ventricular ejection fraction was 57.5%, similar to other trials of HFpEF. Most patients were in New York Heart Association class II, and 38% had ≥1 hospitalizations for heart failure within the previous 9 months. Diabetes mellitus (43%) and chronic kidney disease (47%) were more prevalent than in previous trials of HFpEF. Many patients were prescribed angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (85%), β-blockers (80%), calcium channel blockers (36%), and mineralocorticoid receptor antagonists (24%). As specified in the protocol, virtually all patients were on diuretics, had elevated plasma concentrations of N-terminal pro-B-type natriuretic peptide (median, 911 pg/mL; interquartile range, 464–1610), and structural heart disease.

Conclusions:
PARAGON-HF represents a contemporary group of patients with HFpEF with similar age and sex distribution compared with prior HFpEF trials but higher prevalence of comorbidities. These findings provide insights into the impact of inclusion criteria on, and regional variation in, HFpEF patient characteristics.

CLINICAL TRIAL REGISTRATION:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01920711.