Recent data presented at the European Society of Cardiology (ESC) Congress show significant progress in the treatment of heart failure caused by Chagas disease, writes Medical Xpress.

In the first ever prospective randomized trial, sacubitril/valsartan demonstrated a clear advantage over traditional enalapril on the primary composite endpoint, largely due to a reduction in NT-proBNP, a key biomarker of cardiac overload. 

The study, called PARACHUTE-HF, included patients with confirmed Trypanosoma cruzi infection, left ventricular ejection fraction, and elevated NT-proBNP levels, or who had recently been hospitalized for heart failure. Participants were divided into two groups: sacubitril/valsartan titrated to 200 mg twice daily and enalapril up to 10 mg twice daily. The primary outcome was cardiovascular mortality, first hospitalization for heart failure, and changes in NT-proBNP at 12 weeks, using the win-ratio method.

Sacubitril/valsartan was 52% more likely to achieve a more favorable outcome than enalapril.

At the same time, mortality and hospitalizations did not differ statistically significantly between the groups, but the reduction in NT-proBNP after 12 weeks was −30.6% versus −5.5%, which was a key factor in the success. The safety profiles of both drugs were comparable: side effects led to discontinuation of treatment in 6.1% of patients in the sacubitril/valsartan group and 9.8% in the enalapril group.