Photo Credit: lawanastudio

The following is a summary of “Impact of Race on Sacubitril/Valsartan use of HF,” published in the October 2024 issue of Cardiology by Lu et al.  

There is limited understanding of how self-reported race affects the safety and effectiveness of sacubitril/valsartan in patients with heart failure (HF).   

Researchers conducted a prospective study exploring the relationship between self-reported race and the outcomes of using sacubitril/valsartan in HF treatment.   

They conducted a post hoc pooled analysis of the PARADIGM-HF and PARAGON-HF trials, focusing on participants identified as White, Asian, or Black. The study examined various health outcomes, including cardiovascular death and hospitalization rates, while excluding those with angioedema during the medication run-in. The primary goal was to assess cardiovascular death or first HF hospitalization while also looking at various safety and outcome measures, including angioedema rates.   

The results showed that the analysis included 12,097 participants: 9,451 White (78.1%), 2,116 Asian (17.5%), and 530 Black (4.4%). The median follow-up was 2.5 years. Black participants had a higher risk for the primary outcome (aHR 1.68; 95% CI: 1.42-1.98) than White, as did Asian participants (aHR 1.32; 95% CI: 1.18-1.47). The treatment effect of sacubitril/valsartan was similar across races, and safety outcomes were comparable. Rates of severe angioedema were slightly higher with sacubitril/valsartan versus RAS inhibitors for Black (1.5% vs. 0.0%) and similar for other races.   

Investigators concluded that Black and Asian participants with HF had a higher adjusted risk for cardiovascular death or hospitalization compared to White participants. In comparison, the benefits of sacubitril/valsartan were similar across all racial groups despite a slightly higher risk of severe angioedema.   

Source: acc.org/Latest-in-Cardiology/Journal-Scans/2024/10/23/16/47/race-in-heart-failure