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Omecamtiv Mecarbil in Chronic Heart Failure With Reduced Ejection Fraction: Rationale and Design of GALACTIC-HF.

Publication ,  Journal Article
Teerlink, JR; Diaz, R; Felker, GM; McMurray, JJV; Metra, M; Solomon, SD; Legg, JC; Büchele, G; Varin, C; Kurtz, CE; Malik, FI; Honarpour, N
Published in: JACC Heart Fail
April 2020

A central factor in the pathogenesis of heart failure (HF) with reduced ejection fraction is the initial decrease in systolic function. Prior attempts at increasing cardiac contractility with oral drugs have uniformly resulted in signals of increased mortality at pharmacologically effective doses. Omecamtiv mecarbil is a novel, selective cardiac myosin activator that has been shown to improve cardiac function and to decrease ventricular volumes, heart rate, and N-terminal pro-B-type natriuretic peptide in patients with chronic HF. The GALACTIC-HF (Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure) trial tests the hypotheses that omecamtiv mecarbil can safely improve symptoms, prevent clinical HF events, and delay CV death in patients with chronic HF. The GALACTIC-HF trial is an international, multicenter, randomized, double-blind, placebo-controlled, event-driven cardiovascular outcomes trial. More than 8,000 patients with chronic symptomatic (New York Heart Association functional class II to IV) HF, left ventricular ejection fraction ≤35%, elevated natriuretic peptides, and either current hospitalization for HF or history of hospitalization or emergency department visit for HF within a year of screening will be randomized to either oral placebo or omecamtiv mecarbil employing a pharmacokinetic-guided dose titration strategy using doses of 25, 37.5, or 50 mg twice daily. The primary efficacy outcome is the time to cardiovascular death or first HF event. The study has 90% power to assess a final hazard ratio of approximately 0.80 in cardiovascular death, the first secondary outcome. The GALACTIC-HF trial is the first trial examining whether selectively increasing cardiac contractility in patients with HF with reduced ejection fraction will result in improved clinical outcomes. (Registrational Study With Omecamtiv Mecarbil/AMG 423 to Treat Chronic Heart Failure With Reduced Ejection Fraction [GALACTIC-HF]; NCT02929329).

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Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

April 2020

Volume

8

Issue

4

Start / End Page

329 / 340

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Urea
  • Stroke Volume
  • Randomized Controlled Trials as Topic
  • Myocardial Contraction
  • Humans
  • Heart Failure
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

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Teerlink, J. R., Diaz, R., Felker, G. M., McMurray, J. J. V., Metra, M., Solomon, S. D., … Honarpour, N. (2020). Omecamtiv Mecarbil in Chronic Heart Failure With Reduced Ejection Fraction: Rationale and Design of GALACTIC-HF. JACC Heart Fail, 8(4), 329–340. https://doi.org/10.1016/j.jchf.2019.12.001
Teerlink, John R., Rafael Diaz, G Michael Felker, John J. V. McMurray, Marco Metra, Scott D. Solomon, Jason C. Legg, et al. “Omecamtiv Mecarbil in Chronic Heart Failure With Reduced Ejection Fraction: Rationale and Design of GALACTIC-HF.JACC Heart Fail 8, no. 4 (April 2020): 329–40. https://doi.org/10.1016/j.jchf.2019.12.001.
Teerlink JR, Diaz R, Felker GM, McMurray JJV, Metra M, Solomon SD, et al. Omecamtiv Mecarbil in Chronic Heart Failure With Reduced Ejection Fraction: Rationale and Design of GALACTIC-HF. JACC Heart Fail. 2020 Apr;8(4):329–40.
Teerlink, John R., et al. “Omecamtiv Mecarbil in Chronic Heart Failure With Reduced Ejection Fraction: Rationale and Design of GALACTIC-HF.JACC Heart Fail, vol. 8, no. 4, Apr. 2020, pp. 329–40. Pubmed, doi:10.1016/j.jchf.2019.12.001.
Teerlink JR, Diaz R, Felker GM, McMurray JJV, Metra M, Solomon SD, Legg JC, Büchele G, Varin C, Kurtz CE, Malik FI, Honarpour N. Omecamtiv Mecarbil in Chronic Heart Failure With Reduced Ejection Fraction: Rationale and Design of GALACTIC-HF. JACC Heart Fail. 2020 Apr;8(4):329–340.
Journal cover image

Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

April 2020

Volume

8

Issue

4

Start / End Page

329 / 340

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Urea
  • Stroke Volume
  • Randomized Controlled Trials as Topic
  • Myocardial Contraction
  • Humans
  • Heart Failure
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology