Evidence map›Paper›PMID 37813587›Full record

ArticleESC heart failure2024

Heart failure with preserved ejection fraction, red cell distribution width, and sacubitril/valsartan.

Jawad H Butt, Kirsty McDowell, Toru Kondo, Akshay S Desai, Martin P Lefkowitz, Milton Packer, Mark C Petrie, Marc A Pfeffer, Jean L Rouleau, Muthiah Vaduganathan and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Jawad H ButtBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK.
Kirsty McDowellBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK.
Toru KondoBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK.
Akshay S DesaiCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Martin P LefkowitzNovartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
Milton PackerBaylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX, USA.
Mark C PetrieBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK.
Marc A PfefferCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Jean L RouleauInstitut de Cardiologie de Montréal, Université de Montréal, Montreal, QC, Canada.
Muthiah VaduganathanCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Michael R ZileMedical University of South Carolina and Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA.
Pardeep S JhundBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK.
Lars KøberDepartment of Cardiology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.
Scott SolomonCardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
John J V McMurrayBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK.

Funding

British Heart Foundation Centre of Research Excellence RE/18/6/34217Novartis
6 · The paper itself

Abstract

aimsRed cell distribution width (RDW) is a strong prognostic marker in patients with heart failure (HF) and reduced ejection fraction and other conditions. However, very little is known about its prognostic significance in HF with preserved ejection fraction. We examined the relationship between RDW and outcomes and the effect of sacubitril/valsartan, compared with valsartan, on RDW and clinical outcomes in PARAGON-HF. METHODS AND

resultsPARAGON-HF enrolled patients with a left ventricular ejection fraction of ≥45%, structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP). The primary endpoint was a composite of total HF hospitalizations and cardiovascular deaths. Median RDW at randomization was 14.1% (interquartile range 13.5-15.0%). Patients with higher RDW levels were more often men and had more comorbidity, a higher heart rate and NT-proBNP concentration, more advanced New York Heart Association class, and worse Kansas City Cardiomyopathy Questionnaire scores. There was a graded relationship between quartiles of RDW at randomization and the primary endpoint, with a significantly higher risk associated with increasing RDW, even after adjustment for NT-proBNP and other prognostic variables {Quartile 1, reference; Quartile 2, rate ratio 1.03 [95% confidence interval (CI) 0.83 to 1.28]; Quartile 3, 1.25 [1.01 to 1.54]; Quartile 4, 1.70 [1.39 to 2.08]}. This association was seen for each of the secondary outcomes, including cardiovascular and all-cause death. Compared with valsartan, sacubitril/valsartan reduced RDW at 48 weeks [mean change -0.09 (95% CI -0.15 to -0.02)]. The effect of sacubitril/valsartan vs. valsartan was not significantly modified by RDW levels at randomization.

conclusionsRDW, a routinely available and inexpensive biomarker, provides incremental prognostic information when added to established predictors. Compared with valsartan, sacubitril/valsartan led to a small reduction in RDW.

Indexed as

AminobutyratesBiphenyl CompoundsErythrocyte IndicesHeart FailureAngiotensin Receptor AntagonistsHumansMaleStroke VolumeTetrazolesValsartanVentricular Function, LeftAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundssacubitrilTetrazolesValsartanClinical trialHeart failureOutcomesRed cell width distributionSacubitril-valsartan

Identifiers

PMID37813587
PMCPMC10804200

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.