2024
Sacubitril/Valsartan in Patients Hospitalized With Decompensated Heart Failure
Morrow D, Velazquez E, Desai A, DeVore A, Lepage S, Park J, Sharma K, Solomon S, Starling R, Ward J, Williamson K, Zieroth S, Hernandez A, Mentz R, Braunwald E. Sacubitril/Valsartan in Patients Hospitalized With Decompensated Heart Failure. Journal Of The American College Of Cardiology 2024, 83: 1123-1132. PMID: 38508844, DOI: 10.1016/j.jacc.2024.01.027.Peer-Reviewed Original ResearchConceptsWorsening heart failureHeart failureEjection fractionNT-proBNPSpectrum of EFPIONEER-HFSpectrum of left ventricular ejection fractionRandomized trialsTime-averaged proportional changeN-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptideLeft ventricular ejection fractionWorsening heart failure eventDecompensated heart failureVentricular ejection fractionPlasma NT-proBNPPIONEER-HF trialDouble-blindMedian ageMedian EFSNatriuretic peptideSymptomatic hypotensionBaseline characteristicsClinical outcomesPooled analysis
2020
Initiation of Angiotensin-Neprilysin Inhibition After Acute Decompensated Heart Failure
DeVore AD, Braunwald E, Morrow DA, Duffy CI, Ambrosy AP, Chakraborty H, McCague K, Rocha R, Velazquez EJ. Initiation of Angiotensin-Neprilysin Inhibition After Acute Decompensated Heart Failure. JAMA Cardiology 2020, 5: 202-207. PMID: 31825471, PMCID: PMC6990764, DOI: 10.1001/jamacardio.2019.4665.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAminobutyratesAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsBiphenyl CompoundsDrug CombinationsEnalaprilFemaleHeart FailureHospitalizationHumansMaleMiddle AgedNatriuretic Peptide, BrainNeprilysinPatient DischargePeptide FragmentsTetrazolesValsartanConceptsAcute decompensated heart failureSacubitril/valsartanNT-proBNP levelsDecompensated heart failureOpen-label studyReduced ejection fractionHospital initiationHeart failurePIONEER-HFEjection fractionWeek 8N-terminal pro-B-type natriuretic peptide levelsPro-B-type natriuretic peptide levelsOpen-label extension phaseAngiotensin-Neprilysin InhibitionHeart failure rehospitalizationPIONEER-HF trialWeek 8 visitNatriuretic peptide levelsActive-controlled trialCardiovascular deathComposite outcomeHemodynamic stabilityRecent hospitalizationClinical outcomes
2019
Representativeness of the PIONEER-HF Clinical Trial Population in Patients Hospitalized with Heart Failure
Sayeed S, Fudim M, Xu H, Matsouaka R, Heidenreich P, Yancy C, Fonarow G, Velazquez E, Hernandez A, DeVore A. Representativeness of the PIONEER-HF Clinical Trial Population in Patients Hospitalized with Heart Failure. Journal Of Cardiac Failure 2019, 25: s151. DOI: 10.1016/j.cardfail.2019.07.436.Peer-Reviewed Original ResearchAcute decompensated heart failurePIONEER-HF trialSacubitril/valsartanHFrEF patientsCause mortalityEjection fractionEligible cohortHeart failureLeft ventricular ejection fractionGWTG-HF registryHF rehospitalization ratesDecompensated heart failureReduced ejection fractionInitial study populationVentricular ejection fractionClinical trial populationsLong-term outcomesDaily clinical practiceTrial eligibility criteriaGWTG-HFHF hospitalizationHospital initiationPIONEER-HFHF readmissionIndex dischargeSacubitril/Valsartan Initiated in Black Patients Admitted for Acute Decompensated Heart Failure Reduced NT-proBNP, was Safe and Led to Improved Clinical Outcomes- A Secondary Analysis of the PIONEER-HF Trial
Velazquez E, Ambrosy A, Morrow D, McCague K, Duffy C, O'Brien T, Rocha R, DeVore A, Braunwald E. Sacubitril/Valsartan Initiated in Black Patients Admitted for Acute Decompensated Heart Failure Reduced NT-proBNP, was Safe and Led to Improved Clinical Outcomes- A Secondary Analysis of the PIONEER-HF Trial. Journal Of Cardiac Failure 2019, 25: s80. DOI: 10.1016/j.cardfail.2019.07.227.Peer-Reviewed Original ResearchAcute decompensated HFPIONEER-HF trialHeart failureNT-proBNPBlack patientsPg/mLAngioedema eventsHospital initiationClinical outcomesAcute decompensated heart failureAngiotensin receptor neprilysin inhibitorPre-specified subgroup analysisPrior heart failureACEI/ARBDecompensated heart failureNatriuretic peptide levelsSacubitril/valsartanImproved clinical outcomesSelf-reported raceCV deathEnalapril armHemodynamic stabilizationSymptomatic hypotensionRenal functionNeprilysin inhibitorIn‐hospital initiation of sacubitril/valsartan in acute decompensated heart failure: being in the right place at the right time
Ambrosy AP, DeVore AD, Velazquez EJ. In‐hospital initiation of sacubitril/valsartan in acute decompensated heart failure: being in the right place at the right time. European Journal Of Heart Failure 2019, 21: 1008-1011. PMID: 31218805, DOI: 10.1002/ejhf.1540.Peer-Reviewed Original ResearchRenal Effects of Intensive Volume Removal in Heart Failure Patients With Preexisting Worsening Renal Function
Rao VS, Ahmad T, Brisco-Bacik MA, Bonventre JV, Wilson FP, Siew ED, Felker GM, Anstrom KK, Mahoney DD, Bart BA, Tang WHW, Velazquez EJ, Testani JM. Renal Effects of Intensive Volume Removal in Heart Failure Patients With Preexisting Worsening Renal Function. Circulation Heart Failure 2019, 12: e005552. PMID: 31163974, PMCID: PMC6585463, DOI: 10.1161/circheartfailure.118.005552.Peer-Reviewed Original ResearchConceptsRenal tubular injury biomarkersTubular injury biomarkersHeart failure patientsAcute decompensated heart failure patientsDecompensated heart failure patientsTubular injury markersInjury biomarkersFailure patientsRenal functionInjury markersAcute decompensated heart failureVolume removalCARRESS-HF trialRenal function recoveryDecompensated heart failureRenal tubular injuryRenal effectsSerum creatinineTubular injuryBiomarker substudyHeart failurePharmacological therapyClinical outcomesFunction recoveryHigh incidenceCardiovascular biomarkers in patients with acute decompensated heart failure randomized to sacubitril-valsartan or enalapril in the PIONEER-HF trial
Morrow DA, Velazquez EJ, DeVore AD, Prescott MF, Duffy CI, Gurmu Y, McCague K, Rocha R, Braunwald E. Cardiovascular biomarkers in patients with acute decompensated heart failure randomized to sacubitril-valsartan or enalapril in the PIONEER-HF trial. European Heart Journal 2019, 40: 3345-3352. PMID: 31093657, PMCID: PMC6801941, DOI: 10.1093/eurheartj/ehz240.Peer-Reviewed Original ResearchConceptsSacubitril/valsartanAcute decompensated HFAcute decompensated heart failureSoluble ST2Decompensated heart failureHeart failureUrinary cGMPMyocardial stressHigh-sensitivity cardiac troponinCyclic guanosine 3'5PIONEER-HF trialDouble-blind trialReduced ejection fractionMultivariable-adjusted analysesGreater reductionNatriuretic peptide receptorPIONEER-HFCardiovascular deathCardiac afterloadHaemodynamic stabilizationEjection fractionHospitalized patientsMyocardial injuryCardiovascular biomarkersTreatment groupsClinical Outcomes in Patients With Acute Decompensated Heart Failure Randomly Assigned to Sacubitril/Valsartan or Enalapril in the PIONEER-HF Trial
Morrow DA, Velazquez EJ, DeVore AD, Desai AS, Duffy CI, Ambrosy AP, Gurmu Y, McCague K, Rocha R, Braunwald E. Clinical Outcomes in Patients With Acute Decompensated Heart Failure Randomly Assigned to Sacubitril/Valsartan or Enalapril in the PIONEER-HF Trial. Circulation 2019, 139: 2285-2288. PMID: 30955360, DOI: 10.1161/circulationaha.118.039331.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failurePIONEER-HF trialDecompensated heart failureSacubitril/valsartanHeart failureClinical outcomesEnalaprilPatientsValsartanTrials
2018
Angiotensin–Neprilysin Inhibition in Acute Decompensated Heart Failure
Velazquez EJ, Morrow DA, DeVore AD, Duffy CI, Ambrosy AP, McCague K, Rocha R, Braunwald E. Angiotensin–Neprilysin Inhibition in Acute Decompensated Heart Failure. New England Journal Of Medicine 2018, 380: 539-548. PMID: 30415601, DOI: 10.1056/nejmoa1812851.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAminobutyratesAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsBiphenyl CompoundsCardiac Output, LowDose-Response Relationship, DrugDouble-Blind MethodDrug CombinationsEnalaprilFemaleHeart FailureHumansMaleMiddle AgedNatriuretic Peptide, BrainNeprilysinPeptide FragmentsStroke VolumeTetrazolesValsartanConceptsAcute decompensated heart failureDecompensated heart failureNT-proBNP concentrationsSacubitril-valsartan groupSacubitril-valsartan therapyReduced ejection fractionHeart failureSymptomatic hypotensionRenal functionEnalapril groupEjection fractionWeek 4N-terminal pro-B-type natriuretic peptide concentrationsAngiotensin-Neprilysin InhibitionKey safety outcomePrimary efficacy outcomeNatriuretic peptide concentrationsGreater reductionEnalapril therapyEfficacy outcomesHemodynamic stabilizationSafety outcomesBaseline valuesWeek 1PatientsRationale and design of the comParIson Of sacubitril/valsartaN versus Enalapril on Effect on nt-pRo-bnp in patients stabilized from an acute Heart Failure episode (PIONEER-HF) trial
Velazquez EJ, Morrow DA, DeVore AD, Ambrosy AP, Duffy CI, McCague K, Hernandez AF, Rocha RA, Braunwald E. Rationale and design of the comParIson Of sacubitril/valsartaN versus Enalapril on Effect on nt-pRo-bnp in patients stabilized from an acute Heart Failure episode (PIONEER-HF) trial. American Heart Journal 2018, 198: 145-151. PMID: 29653636, DOI: 10.1016/j.ahj.2018.01.004.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedAminobutyratesBiphenyl CompoundsCardiac Output, LowCause of DeathDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleDrug CombinationsDrug Delivery SystemsEnalaprilFemaleHeart FailureHumansMaleMiddle AgedNatriuretic Peptide, BrainPatient SafetyPeptide FragmentsPrognosisProspective StudiesRisk AssessmentSeverity of Illness IndexSurvival RateTetrazolesTreatment OutcomeValsartanConceptsAcute decompensated heart failureSacubitril/valsartanB-type natriuretic peptideDecompensated heart failureAmino-terminal pro-B-type natriuretic peptideTerminal pro-B-type natriuretic peptideEjection fractionHeart failureHospital initiationNatriuretic peptideEnd pointClass angiotensin receptor neprilysin inhibitorAngiotensin receptor neprilysin inhibitorPg/Primary efficacy end pointAmbulatory HF patientsExploratory end pointsPIONEER-HF trialEfficacy end pointReduced ejection fractionSafety end pointOpen-label treatmentIncidence of angioedemaYears of agePIONEER-HF
2015
Torsemide Versus Furosemide in Patients With Acute Heart Failure (from the ASCEND-HF Trial)
Mentz RJ, Hasselblad V, DeVore AD, Metra M, Voors AA, Armstrong PW, Ezekowitz JA, Tang WH, Schulte PJ, Anstrom KJ, Hernandez AF, Velazquez EJ, O'Connor CM. Torsemide Versus Furosemide in Patients With Acute Heart Failure (from the ASCEND-HF Trial). The American Journal Of Cardiology 2015, 117: 404-411. PMID: 26704029, PMCID: PMC4718787, DOI: 10.1016/j.amjcard.2015.10.059.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedCause of DeathDose-Response Relationship, DrugDouble-Blind MethodFemaleFollow-Up StudiesFurosemideGlobal HealthHeart FailureHospitalizationHumansMaleMiddle AgedRetrospective StudiesSodium Potassium Chloride Symporter InhibitorsStroke VolumeSulfonamidesSurvival RateTorsemideTreatment OutcomeConceptsHeart failureChoice of diureticAcute heart failureDecompensated heart failureNatriuretic peptide levelsLow ejection fractionComparative effectiveness trialHF hospitalizationBlood pressureEjection fractionUnadjusted analysesAcute studyClinical effectivenessEffectiveness trialPeptide levelsPatientsFurosemideSimilar outcomesInverse probabilityPotential pharmacologicTorsemideDiureticsMortalityTrialsFailure
2012
Ultrafiltration in Decompensated Heart Failure with Cardiorenal Syndrome
Bart B, Goldsmith SR, Lee KL, Givertz MM, O'Connor CM, Bull DA, Redfield MM, Deswal A, Rouleau JL, LeWinter MM, Ofili EO, Stevenson LW, Semigran MJ, Felker GM, Chen HH, Hernandez AF, Anstrom KJ, McNulty SE, Velazquez EJ, Ibarra JC, Mascette AM, Braunwald E. Ultrafiltration in Decompensated Heart Failure with Cardiorenal Syndrome. New England Journal Of Medicine 2012, 367: 2296-2304. PMID: 23131078, PMCID: PMC3690472, DOI: 10.1056/nejmoa1210357.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureSerum creatinine levelsHeart failureUltrafiltration groupRenal functionCreatinine levelsPharmacologic therapyAdverse eventsEnd pointSafety of ultrafiltrationPrimary end pointSerious adverse eventsTreatment of patientsPersistent congestionDiuretic therapyCardiorenal syndromeRandomized trialsMean changePatientsBody weightWeight lossTherapySignificant differencesHigh rate
2011
Diuretic Strategies in Patients with Acute Decompensated Heart Failure
Felker GM, Lee KL, Bull DA, Redfield MM, Stevenson LW, Goldsmith SR, LeWinter MM, Deswal A, Rouleau JL, Ofili EO, Anstrom KJ, Hernandez AF, McNulty SE, Velazquez EJ, Kfoury AG, Chen HH, Givertz MM, Semigran MJ, Bart B, Mascette AM, Braunwald E, O'Connor CM. Diuretic Strategies in Patients with Acute Decompensated Heart Failure. New England Journal Of Medicine 2011, 364: 797-805. PMID: 21366472, PMCID: PMC3412356, DOI: 10.1056/nejmoa1005419.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedArea Under CurveCreatinineDiureticsDouble-Blind MethodDrug Administration ScheduleDyspneaFemaleFurosemideHeart FailureHumansInfusions, IntravenousInjections, IntravenousIntention to Treat AnalysisKaplan-Meier EstimateMaleMiddle AgedSodium Potassium Chloride Symporter InhibitorsConceptsAcute decompensated heart failureDecompensated heart failurePatient global assessmentHeart failureCreatinine levelsContinuous infusionHigh-dose strategyGlobal assessmentRenal functionMean changeLow doseHigh doseSignificant differencesCoprimary end pointsSerum creatinine levelsHigh-dose groupLow-dose strategyVisual analog scaleComparison of BolusDiuretic strategyDiuretic therapyTransient worseningGreater diuresisDose adjustmentLoop diuretics