Author + information
- Jelena Seferovic,
- Sara Seidelmann,
- Brian Clagett,
- Milton Packer,
- Michael Zile,
- Jean Rouleau,
- Karl Swedberg,
- Martin Lefkowitz,
- Victor Shi,
- Akshay Desai,
- John J.V. McMurray and
- Scott Solomon
Background: Type 2 diabetes (T2DM) is an independent risk factor for heart failure progression. Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor, improves morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF) and was shown to improve peripheral insulin sensitivity in obese hypertensive patients.
Methods: The PARADIGM-HF trial randomized 8399 subjects with HFrEF to treatment with sacubitril/valsartan or enalapril. We assessed changes in glycemic control by assessing glycated hemoglobin (HbA1c) among the subset of patients with known T2DM or screening HbA1c ≥6.5% (n=3778) in a mixed effects longitudinal analysis model.
Results: There were no differences in HbA1c levels between randomized groups at screening (Table 1). During the follow-up, HbA1c decreased significantly in both treatment groups (p<0.001), and this decline was greater in patients receiving sacubitril/valsartan compared to those receiving enalapril (overall p=0.001). Plasma glucose was slightly but non-significantly reduced in the sacubtril/valsartan arm.
Conclusions: Patients with T2DM and HFrEF enrolled in PARADIGM-HF who received sacubitril/valsartan had a greater reduction in HbA1c than those receiving enalapril, despite minimal effects on fasting plasma glucose. These data suggest that sacubitril/valsartan could enhance glycemic control in patients with T2DM and HFrEF.
Moderated Poster Contributions
Heart Failure and Cardiomyopathies Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-9:55 a.m.
Session Title: The Old and the New: Impact of Heart Failure Drug Therapies
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1216M-03
- 2017 American College of Cardiology Foundation