New: The effect of LCZ696 (Entresto) on cardiovascular death in heart failure patients

This study compared the effectiveness of the new drug LCZ696 to enalapril at reducing cardiovascular death in patients with heart failure.

Patients with chronic heart failure (when the heart is not able to pump enough blood) are at a high risk of disease progression and death. Treatments for heart failure include angiotensin-converting enzyme (ACE) inhibitors, such as enalapril (Vasotec). These treatment help relax the blood vessels, improving blood flow.

LCZ696 (valsartan, or Entresto) is a new treatment that targets both heart failure and reduced ejection fraction (when the heart does not contract properly and blood is not pumped effectively). LCZ696 helps stop blood vessels from constricting and blocking blood flow. LCZ696 reduced heart failure hospitalizations, as well as all-cause mortality. It is not yet clear how LCZ696 affects different causes of mortality in heart failure patients compared to other heart failure treatments.

This study included 8399 patients with heart failure. Patients were randomly assigned to receive treatment with either LCZ696 or enalapril. 17% of the LCZ696 group and 19.8% of the enalapril group died during the study. The causes of death were compared between the two groups.

80.9% of the deaths during the study were due to cardiovascular causes (13% of the LCZ696 group and 16.5% from the enalapril group). The risk of cardiovascular death was reduced by 20% with LCZ696 in comparison to enalapril. The risk of death due to worsening heart failure was decreased by 21% with LCZ696 as opposed to enalapril. The risk of sudden cardiac death was reduced by 20% with LCZ696.

The number of deaths due to heart attack or stroke were small, and did not differ between the two groups. Non-cardiovascular death rates were similar in both groups.

This study concluded that LCZ696 reduced the risk of sudden death due to cardiovascular reasons and heart failure compared to enalapril.

This study was funded by Novartis, the manufacturers of LCZ696.

Discuss the risks and benefits of LCZ696 with your physician.