PARADIGM-HF试验及其重要的临床意义

PARADIGM-HF trial and its important clinical significance

ACEI/ARB＋β受体阻滞剂＋醛固酮拮抗剂已经成为临床射血分数降低心力衰竭（EFrHF）治疗的金标准。本文简述了PARADIGM-HF临床试验，结果显示：与依那普利组比较， LCZ696（ARNI）治疗组主要复合终点[HR 0.80（95%CI 0.73～0.87），P＜0.001]、心血管死亡[HR 0.80（95%CI 0.71～0.89），P＜0.001]、因心力衰竭住院[HR 0.79（95%CI 0.71～0.89），P＜0.001]和全因死亡[HR 0.84（95%CI 0.76～0.93），P＜0.001]均显著降低，而且安全性良好。PARADIGM-HF研究意义重大，有可能改变未来心力衰竭的治疗格局。

ACEI/ARB andβblocker and aldosterone antagonist have been a gold standard for treating chronic heart failure with reduced ejection fraction （EFrHF）. The paper described simply the PARADIGM-HF （prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in HF trial）, and the results showed that comparing with the enalapril group, LCZ696（ARNI） reduced significantly primary endpoint （cardiovascular death or hospitalization for HF） [HR 0.80 （95%CI 0.73-0.87）, P〈0.001], cardiovascular death[HR 0.80 （95%CI 0.71-0.89）, P〈0.001], hospitalization for HF [HR 0.79 （95% CI 0.71-0.89）, P〈0.001] , and death from any cause [HR 0.84 （95% CI 0.76-0.93）, P〈0.001]. LCZ696 was well tolerated. The PARADIGM-HF study has an important clinical significance and would change the pattern of HF treatment in the future.