Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomised controlled trials

Study (n=15880) found mineralocorticoid receptor antagonists, angiotensin receptor–neprilysin inhibitors & sodium/glucose cotransporter 2 inhibitors reduced mortality beyond standard therapy (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers & β-blockers)

SPS commentary:

In a related commentary, authors highlight that this model is a necessary part of clinical decision making in assessing the relative benefit of adding new therapies to a current treatment regimen.

Treatment with comprehensive disease-modifying pharmacological therapy was estimated to afford 2.7 additional years (for an 80-year-old) to 8.3 additional years (for a 55-year-old) free from cardiovascular death or first hospital admission for heart failure and 1.4 additional years (for an 80-year-old) to 6.3 additional years (for a 55-year-old) of survival compared with conventional therapy. Hazard ratios were also favourable for cardiovascular death (HR 0.50 [95% CI 0.37–0.67]), hospital admission for heart failure (0.32 [0.24–0.43]), and all-cause mortality (0.53 [0.40–0.70]).


The Lancet

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