Letter to the Editor
Response to the Letter to the Editor – “The PARADIGM-HF population may be very different from real-world heart failure patients”
Resposta à Carta ao Editor «A população do PARADIGM-HF pode ser muito diferente do mundo real dos doentes com insuficiência cardíaca»
Gustavo Rodrigues
, António Tralhão, Carlos Aguiar, Pedro Freitas, António Ventosa, Miguel Mendes
Corresponding author
Hospital de Santa Cruz, CHLO, Lisbon, Portugal
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"identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "António" "apellidos" => "Tralhão" ] 2 => array:2 [ "nombre" => "Carlos" "apellidos" => "Aguiar" ] 3 => array:2 [ "nombre" => "Pedro" "apellidos" => "Freitas" ] 4 => array:2 [ "nombre" => "António" "apellidos" => "Ventosa" ] 5 => array:2 [ "nombre" => "Miguel" "apellidos" => "Mendes" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Hospital de Santa Cruz, CHLO, Lisbon, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Resposta à Carta ao Editor «A população do PARADIGM-HF pode ser muito diferente do mundo real dos doentes com insuficiência cardíaca»" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">As highlighted by our analysis,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> the epidemiological study in Lima<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> pertinently quoted by Walter Calderón, and another two large registries,<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">3,4</span></a> patients from randomized trials are frequently different from those found in our daily practice. However, the results of the PARADIGM-HF trial are changing and will continue to change the way we treat patients with heart failure and reduced ejection fraction.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Recently, the TRANSITION trial demonstrated the safety of sacubitril/valsartan when initiated prior to discharge from hospitalization for heart failure, achieving similar titration rates (62% vs. 68%),<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> and PIONEER-HF showed that in-hospital initiation of sacubitril/valsartan further reduced NT-proBNP values (ratio of NT-proBNP at week 4 and 8 to baseline value: 0.53 vs. 0.75).<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Concluding, different pieces of an intricate puzzle are coming together, contributing to the widespread adoption of neuromodulation in patients with heart failure and reduced ejection fraction.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is the PARADIGM-HF cohort representative of the real-world heart failure patient population?" 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DeVore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1602003" "Revista" => array:3 [ "tituloSerie" => "N Engl J Med" "fecha" => "2018" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27040451" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003800000002/v1_201904100624/S2174204919300765/v1_201904100624/en/main.assets" "Apartado" => array:4 [ "identificador" => "29282" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003800000002/v1_201904100624/S2174204919300765/v1_201904100624/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204919300765?idApp=UINPBA00004E" ]
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