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Plasma renin activity, response to aliskiren, and clinical outcomes in patients hospitalized for heart failure: the ASTRONAUT trial.


ABSTRACT: AIMS:The direct renin inhibitor, aliskiren, is known to reduce plasma renin activity (PRA), but whether the efficacy of aliskiren varies based on an individual's baseline PRA in patients hospitalized for heart failure (HF) is presently unknown. We characterized the prognostic value of PRA and determined if this risk is modifiable with use of aliskiren. METHODS AND RESULTS:This pre-specified neurohormonal substudy of ASTRONAUT analysed all patients hospitalized for HF with ejection fraction (EF) ?40% with available baseline PRA data (n?=?1306, 80.9%). Risk associated with baseline PRA and short-term changes in PRA from baseline to 1?month was modelled with respect to 12-month clinical events. Median baseline PRA was 3.0 (interquartile range 0.6-16.4) ng/mL/h. Aliskiren significantly reduced PRA early after treatment initiation through 12-month follow-up compared with placebo (P?

SUBMITTER: Vaduganathan M 

PROVIDER: S-EPMC6676477 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Plasma renin activity, response to aliskiren, and clinical outcomes in patients hospitalized for heart failure: the ASTRONAUT trial.

Vaduganathan Muthiah M   Cheema Baljash B   Cleveland Erin E   Sankar Kamya K   Subacius Haris H   Fonarow Gregg C GC   Solomon Scott D SD   Lewis Eldrin F EF   Greene Stephen J SJ   Maggioni Aldo P AP   Böhm Michael M   Zannad Faiez F   Butler Javed J   Gheorghiade Mihai M  

European journal of heart failure 20171116 4


<h4>Aims</h4>The direct renin inhibitor, aliskiren, is known to reduce plasma renin activity (PRA), but whether the efficacy of aliskiren varies based on an individual's baseline PRA in patients hospitalized for heart failure (HF) is presently unknown. We characterized the prognostic value of PRA and determined if this risk is modifiable with use of aliskiren.<h4>Methods and results</h4>This pre-specified neurohormonal substudy of ASTRONAUT analysed all patients hospitalized for HF with ejection  ...[more]

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