Re-emergence of heart failure with a normal ejection fraction?
Toru Kondo, John J.V. McMurray
Abstract
Interaction between the effect of: (A) the sodium–glucose co-transporter 2 (SGLT2) empagliflozin; from Butler et al.;6 and of (B) the angiotensin receptor blocker (ARB) candesartan; (C) the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril valsartan; (D) the mineralocorticoid receptor antagonists (MRAs) spironolactone and eplerenone; and (E) the digitalis glycoside digoxin according to baseline LVEF in the trials reported by Dewan et al.2 and the Digitalis Investigation Group12. The analysis was similar to that described in panel A. The x-axis shows LVEF and the y-axis the hazard ratio (HR) for the effect of the experimental treatment compared with control therapy on the time to first occurrence of cardiovascular (CV) death or heart failure (HF) hospitalization. A HR <1 indicates benefit. A HR of 1 is indicated by the horizontal solid black line. The other coloured solid lines shows a continuous HR and the interrupted lines on either side of this the 95% confidence interval. Interaction between the effect of: (A) the sodium–glucose co-transporter 2 (SGLT2) empagliflozin; from Butler et al.;6 and of (B) the angiotensin receptor blocker (ARB) candesartan; (C) the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril valsartan; (D) the mineralocorticoid receptor antagonists (MRAs) spironolactone and eplerenone; and (E) the digitalis glycoside digoxin according to baseline LVEF in the trials reported by Dewan et al.2 and the Digitalis Investigation Group12. The analysis was similar to that described in panel A. The x-axis shows LVEF and the y-axis the hazard ratio (HR) for the effect of the experimental treatment compared with control therapy on the time to first occurrence of cardiovascular (CV) death or heart failure (HF) hospitalization. A HR <1 indicates benefit. A HR of 1 is indicated by the horizontal solid black line. The other coloured solid lines shows a continuous HR and the interrupted lines on either side of this the 95% confidence interval.