RT Journal Article
SR 00
ID 10.1056/NEJMoa2025797
A1 Teerlink, John R.
A1 Diaz, Rafael
A1 Felker, G. Michael
A1 McMurray, John J.V.
A1 Metra, Marco
A1 Solomon, Scott D.
A1 Adams, Kirkwood F.
A1 Anand, Inder
A1 Arias-Mendoza, Alexandra
A1 Biering-Sørensen, Tor
A1 Böhm, Michael
A1 Bonderman, Diana
A1 Cleland, John G.F.
A1 Corbalan, Ramon
A1 Crespo-Leiro, Maria G.
A1 Dahlström, Ulf
A1 Echeverria, Luis E.
A1 Fang, James C.
A1 Filippatos, Gerasimos
A1 Fonseca, Cândida
A1 Goncalvesova, Eva
A1 Goudev, Assen R.
A1 Howlett, Jonathan G.
A1 Lanfear, David E.
A1 Li, Jing
A1 Lund, Mayanna
A1 Macdonald, Peter
A1 Mareev, Viacheslav
A1 Momomura, Shin-ichi
A1 O’Meara, Eileen
A1 Parkhomenko, Alexander
A1 Ponikowski, Piotr
A1 Ramires, Felix J.A.
A1 Serpytis, Pranas
A1 Sliwa, Karen
A1 Spinar, Jindrich
A1 Suter, Thomas M.
A1 Tomcsanyi, Janos
A1 Vandekerckhove, Hans
A1 Vinereanu, Dragos
A1 Voors, Adriaan A.
A1 Yilmaz, Mehmet B.
A1 Zannad, Faiez
A1 Sharpsten, Lucie
A1 Legg, Jason C.
A1 Varin, Claire
A1 Honarpour, Narimon
A1 Abbasi, Siddique A.
A1 Malik, Fady I.
A1 Kurtz, Christopher E.
T1 Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure
JF New England Journal of Medicine
YR 2021
FD 2021-01-14
VO 384
SP 105
OP 116
AB Background:  The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown.    Methods:  We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes.    Results:  During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P=0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro–B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups.    Conclusions:  Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329. opens in new tab; EudraCT number, 2016-002299-28. opens in new tab.)
PB Massachusetts Medical Society
SN 0028-4793
LK https://eprints.gla.ac.uk/226483/