PARAGON-HF: Sacubitril/valsartan reduces triglyceride levels in HFpEF
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Sacubitril/valsartan drastically reduced triglycerides compared with valsartan in patients with HF with preserved ejection fraction, according to a presentation at the American College of Cardiology Scientific Session.
In the analysis from the PARAGON-HF study, simultaneously published in the Journal of the American Heart Association, the effect of triglyceride reduction from sacubitril/valsartan (Entresto, Novartis) was greatest in patients with elevated triglycerides.
“Our analysis provides insight into the therapeutic effect of sacubitril/valsartan on serum lipids and the relevance of the natriuretic peptide pathway to effects on triglycerides and HDL-C,” Senthil Selvaraj, MD, cardiovascular disease fellow at Penn Medicine, said in his presentation.
The researchers analyzed 4,744 participants from PARAGON-HF (mean age, 73 years; 52% women) for whom lipid measurements were available, 43% of whom had diabetes.
At 16 weeks, compared with valsartan, sacubitril/valsartan reduced triglycerides by –5% (95% CI, –6.6-3.5; P < .001), increased HDL by 2.6% (95% CI, 1.7-3.4; P < .001) and increased LDL by 1.7% (95% CI, 0.4-3; P = .012), according to the researchers.
The triglyceride reductions in the sacubitril/valsartan group at 16 weeks were –2.5% (95% CI, –4.7 to –0.1) in those with normal baseline triglycerides, –3% (95% CI, –7.5 to 1.6) in those with borderline baseline triglycerides and –13% (95% CI, –18.1 to –7.6) among those with elevated baseline triglycerides.
According to the researchers, the median changes in triglyceride level in the sacubitril/valsartan group were –3 mg/dL (95% CI, –5.5 to –0.4) in those with normal triglycerides, –6.7 mg/dL (95% CI, –15.2 to 1.7) in those with borderline triglycerides and –29.9 mg/dL (95% CI, –44.3 to –15.5) in those with elevated triglycerides.
“The treatment effects on triglycerides and HDL-C were related to sacubitril/valsartan’s effects on natriuretic peptide activity and independent of its effects on hemoglobin A1c,” the researchers wrote in JAHA.
Reference:
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Selvaraj S, et al. Public Health and Heart Failure: Emerging Evidence. Presented at: American College of Cardiology Scientific Session; May 15-17, 2021 (virtual meeting).
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