Sacubitril/valsartan did not affect cognitive function in patients with chronic heart failure with preserved ejection fraction (HFpEF) when compared with valsartan alone, according to results from the PERSPECTIVE trial presented Aug. 26 during ESC Congress 2022 in Barcelona.

The three-year global trial from 137 centers in 20 countries across North America, Latin America, Western Europe, Central/Eastern Europe and Asia-Pacific, randomized 592 patients to either sacubitril/valsartan (n=295) or valsartan alone (n=297). The average patient age was approximately 72 years old and slightly more than 50% of participants were male.

The primary endpoint was the global cognitive composite score from baseline to three years, which was assessed using a comprehensive battery of neuropsychological tests every three months via in-person visits or telephone. Researchers also looked at amyloid β-peptides deposition in the brain using positron emission tomography amyloid imaging at 18 and 36 months.

Overall, researchers said they found no evidence that neprilysin inhibition increased the risk of cognitive impairment due to accumulation of beta-amyloid in the brain of patients with HFpEF. John McMurray, MD, FACC, who presented the findings, noted that sacubitril/valsartan was well tolerated compared with valsartan and that beta-amyloid deposition in the brain, in fact, tended to be less in patients in the sacubitril/valsartan group.

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: ESC Congress, ESC22, Heart Failure, Stroke Volume, Valsartan, Cognition

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