循環器ジャーナル67巻1号

2019年01月発行

特集 循環器の現場からの検証：そのエビデンスを日本で活用するには？ Ⅳ．心不全

PARADIGM-HFはどう解釈されるか？—これからのわが国での慢性期心不全診療

著者： 佐藤幸人¹

所属機関： ¹兵庫県立尼崎総合医療センター循環器内科

ページ範囲：P.110 - P.115

Point
・ARB/NEP阻害薬であるLCZ696は収縮能が低下した心不全患者において，心血管イベント改善効果を伴う忍容性の高い薬剤である．
・欧米のガイドラインでは既に，ACE阻害薬またはARBの代わりに使用することが勧められている．

参考文献

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, Packer M, Black HR, et al:Omapatrilat and enalapril in patients with hypertension:the Omapatrilat Cardiovascular Treatment vs. Enalapril（OCTAVE）trial. Am J Hypertens 17:103-111, 2004

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7) Packer M, McMurray JJ, Desai AS, et al:PARADIGM-HF Investigators and Coordinators:Angiotensin receptor neprilysin inhibition compared with enalapril on the risk of clinical progression in surviving patients with heart failure. Circulation 131:54-61, 2015

8) WRITING COMMITTEE MEMBERS, Yancy CW, Jessup M, et al:2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure:An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure:A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation 134:e282-293, 2016

9) Ponikowski P, Voors AA, Anker SD, et al;Authors/Task Force Members;Document Reviewers:2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology（ESC）. Developed with the special contribution of the Heart Failure Association（HFA）of the ESC. Eur J Heart Fail 18:891-975, 2016

10) Tsutsui H, Momomura S, Saito Y, et al:Efficacy and safety of sacubitril/valsartan（LCZ696）in Japanese patients with chronic heart failure and reduced ejection fraction:Rationale for and design of the randomized, double-blind PARALLEL-HF study. J Cardiol 70:225-231, 2017

11) Solomon SD, Rizkala AR, Gong J, et al:Angiotensin Receptor Neprilysin Inhibition in Heart Failure With Preserved Ejection Fraction:Rationale and Design of the PARAGON-HF Trial. JACC Heart Fail 5:471-482, 2017

12) Burnett H, Earley A, Voors AA, et al:Thirty Years of Evidence on the Efficacy of Drug Treatments for Chronic Heart Failure With Reduced Ejection Fraction:A Network Meta-Analysis. Circ Heart Fail 10:pii:e003529. doi:10.1161/CIRCHEARTFAILURE. 116.003529.

13) McMurray JJ:Neprilysin inhibition to treat heart failure:a tale of science, serendipity, and second chances. Eur J Heart Fail 17:242-247, 2015