Abstract 17955: Reduction in 30-day Rehospitalization After Discharge From a Heart Failure Admission in Patients Receiving LCZ696 versus Enalapril: PARADIGM-HF
Introduction: The angiotensin receptor neprilysin inhibitor LCZ696 reduced cardiovascular death, heart failure hospitalization and all-cause mortality in patients with heart failure and reduced ejection fraction compared with enalapril.
Hypothesis: We hypothesized that LCZ696 would reduce 30-day readmission after a heart failure hospitalization.
Methods: PARADIGM-HF randomized 8399 patients with HF and reduced ejection fraction to either LCZ696 200mg bid or Enalapril 10mg bid. We assessed the risk of 30-day readmission for any cause following investigator reported and adjudicated hospitalization for heart failure. Admission and discharge dates were available for 2800 hospitalizations (95%) in 1638 patients.
Results: Of 2800 HF hospitalizations, 1545 occurred in 871 patients in the enalapril group and 1255 occurred in 767 patients in the LCZ arm. Overall, 10.5% of these HF hospitalizations were followed by a repeat hospitalization for any cause within 30 days of discharge, and this occurred significantly less frequently in the LCZ arm (8.7%) relative to the enalapril arm (12.0%), in both unadjusted models and a random-effects logistic regression model accounting for the repeated HF hospitalizations experienced by some patients. We observed similar results in a sensitivity analysis restricted only to the first HF hospitalization for each patient. Further adjustment for baseline characteristics did not alter these findings. Similar effect sizes were observed for adjudicated heart failure hospitalizations.
Conclusion: In patients admitted with heart failure in PARADIGM-HF, LCZ reduced 30-day readmissions for any-cause.
Author Disclosures: S.D. Solomon: Research Grant; Significant; Novartis. Consultant/Advisory Board; Modest; Novartis. M. Packer: Consultant/Advisory Board; Significant; Novartis. M. Zile: Consultant/Advisory Board; Significant; Novartis. J. Rouleau: Research Grant; Modest; Novartis. Consultant/Advisory Board; Modest; Novartis. K. Swedberg: Research Grant; Modest; Novartis. Consultant/Advisory Board; Modest; Novartis. A. Desai: Research Grant; Modest; Novartis. Consultant/Advisory Board; Modest; Novartis. V. Shi: Employment; Significant; Novartis. Ownership Interest; Significant; Novartis. M. Lefkowitz: Employment; Significant; Novartis. Ownership Interest; Significant; Novartis. J.J. McMurray: Research Grant; Significant; Novartis.
- © 2015 by American Heart Association, Inc.