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For heart attack survivors with left ventricular dysfunction, sacubitril/valsartan (Entresto) was no better than ramipril at reducing heart failure (HF) events in the strictest sense in the PARADISE-MI trial, but several signals nevertheless pointed to potential benefit in some patients.
Acute MI patients shared similar rates of the primary outcome cardiovascular death, HF hospitalization, or outpatient development of HF over a median 23 months whether they had been randomized to sacubitril/valsartan or the angiotensin-converting enzyme (ACE) inhibitor (11.9% vs 13.2%, HR 0.90, 95% CI 0.78-1.04), according to Marc Pfeffer, MD, PhD, of Brigham and Women s Hospital and Harvard Medical School in Boston.