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Relationship between baseline systolic blood pressure and long-term outcomes in acute heart failure patients treated with TRV027: an exploratory subgroup analysis of BLAST-AHF.

Publication ,  Journal Article
Cotter, G; Davison, BA; Butler, J; Collins, SP; Ezekowitz, JA; Felker, GM; Filippatos, G; Levy, PD; Metra, M; Ponikowski, P; Teerlink, JR ...
Published in: Clin Res Cardiol
February 2018

INTRODUCTION: TRV027, a 'biased' ligand of the angiotensin II type 1 receptor (AT1R), did not affect a composite clinical outcome at 30 days in a phase 2b acute heart failure (AHF) trial (BLAST-AHF). METHODS: Post-hoc analyses from BLAST-AHF (n = 618) examined the effects of TRV027 by baseline systolic blood pressure (SBP) on changes in renal function and 180-day outcomes. Interactions between baseline SBP and select endpoints were identified utilizing a subpopulation treatment effect pattern plots (STEPP) analysis, then grouping of patients by SBP tertile: < 127, ≥ 127 to < 140, and ≥ 140 mmHg. RESULTS: A trend towards increased creatinine in the first 3 days was noted in the lower SBP tertile, while in those in the higher two tertiles, TRV027, especially the 1 mg/h dose, reduced creatinine at days 5 and 30. Beneficial effects on 180-day all-cause mortality and cardiovascular (CV) death or readmission were observed in the two higher SBP tertiles (SBP ≥ 127 mmHg) in the TRV027 1 mg/h dose group (all-cause mortality HR 0.39, 95% CI 0.14-1.06, p = 0.056; CV death or HF/RF rehospitalization HR 0.53, 95% CI 0.28-1.01, p = 0.049), while more adverse outcomes were observed in patients in the lower SBP tertile. CONCLUSIONS: This post-hoc analysis of the BLAST-AHF study suggests contrasting effects of TRV027 by baseline SBP, with trends towards lower 180-day event rates in patients enrolled with higher baseline SBP, especially when given lower doses of TRV027.

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Published In

Clin Res Cardiol

DOI

EISSN

1861-0692

Publication Date

February 2018

Volume

107

Issue

2

Start / End Page

170 / 181

Location

Germany

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Systole
  • Signal Transduction
  • Receptor, Angiotensin, Type 1
  • Patient Readmission
  • Oligopeptides
  • Middle Aged
  • Male
 

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Cotter, G., Davison, B. A., Butler, J., Collins, S. P., Ezekowitz, J. A., Felker, G. M., … Pang, P. S. (2018). Relationship between baseline systolic blood pressure and long-term outcomes in acute heart failure patients treated with TRV027: an exploratory subgroup analysis of BLAST-AHF. Clin Res Cardiol, 107(2), 170–181. https://doi.org/10.1007/s00392-017-1168-0
Cotter, Gad, Beth A. Davison, Javed Butler, Sean P. Collins, Justin A. Ezekowitz, G Michael Felker, Gerasimos Filippatos, et al. “Relationship between baseline systolic blood pressure and long-term outcomes in acute heart failure patients treated with TRV027: an exploratory subgroup analysis of BLAST-AHF.Clin Res Cardiol 107, no. 2 (February 2018): 170–81. https://doi.org/10.1007/s00392-017-1168-0.
Cotter G, Davison BA, Butler J, Collins SP, Ezekowitz JA, Felker GM, et al. Relationship between baseline systolic blood pressure and long-term outcomes in acute heart failure patients treated with TRV027: an exploratory subgroup analysis of BLAST-AHF. Clin Res Cardiol. 2018 Feb;107(2):170–81.
Cotter, Gad, et al. “Relationship between baseline systolic blood pressure and long-term outcomes in acute heart failure patients treated with TRV027: an exploratory subgroup analysis of BLAST-AHF.Clin Res Cardiol, vol. 107, no. 2, Feb. 2018, pp. 170–81. Pubmed, doi:10.1007/s00392-017-1168-0.
Cotter G, Davison BA, Butler J, Collins SP, Ezekowitz JA, Felker GM, Filippatos G, Levy PD, Metra M, Ponikowski P, Teerlink JR, Voors AA, Senger S, Bharucha D, Goin K, Soergel DG, Pang PS. Relationship between baseline systolic blood pressure and long-term outcomes in acute heart failure patients treated with TRV027: an exploratory subgroup analysis of BLAST-AHF. Clin Res Cardiol. 2018 Feb;107(2):170–181.
Journal cover image

Published In

Clin Res Cardiol

DOI

EISSN

1861-0692

Publication Date

February 2018

Volume

107

Issue

2

Start / End Page

170 / 181

Location

Germany

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Systole
  • Signal Transduction
  • Receptor, Angiotensin, Type 1
  • Patient Readmission
  • Oligopeptides
  • Middle Aged
  • Male