Excluded population of trial | Included population of trial |
Outcomes of HFrEF GDMT Trials
with serum creatinine-based renal exclusion criteria
Class | Medication | Dialysis | Cr 3.0-3.5 | Cr 2.5-3.0 | Cr 2.0-2.5 | Cr 1.0-2.0 |
---|---|---|---|---|---|---|
ACEI | Enalapril | Excluded | CONSENSUS (1987): Enalapril vs PCB: ↓ACM
Excluded: Cr>3.4 mg/dL
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Excluded | SOLVD (1991): Enalapril vs PCB: ↓ACM, ↓CVM, ↓HFH
Excluded: Cr>2.0 mg/dL
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Captopril | Excluded | SAVE (1992): Captopril vs PCB: ↓ACM, ↓CVM, ↓RMI
Excluded: Cr>2.5 mg/dL
|
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Lisinopril | Excluded | ATLAS (1999): Lisinopril 35mg vs 2.5-5mg: ↓ACH, ↓HFH
Excluded: Cr>2.5 mg/dL
|
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ARB | Valsartan | Excluded | Val-HeFT (2001): Valsartan vs PCB: ↓HFH
Excluded: Cr>2.5 mg/dL
|
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Candesartan | Excluded | CHARM Alt (2003): Candesartan vs PCB: ↓CVM, ↓HFH
Excluded: Cr>3.0 mg/dL
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Losartan | Excluded | HEAAL (2009): Losartan 150mg vs 50mg: ↓ACM, ↓HFH
Excluded: Cr>2.5 mg/dL
|
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BB | Bisoprolol | Excluded | CIBIS (1994): Bisoprolol vs PCB: ↓HFH
Excluded: Cr>3.4 mg/dL
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Excluded | CIBIS II (1999): Bisoprolol vs PCB: ↓ACM, ↓HFH
Excluded: Cr>3.4 mg/dL
|
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Metoprolol | MERIT-HF (1999): Metoprolol vs PCB: ↓ACM, ↓CVM, ↓HFH, ↓SCD
No renal exclusion
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Carvedilol | Excluded | COPERNICUS (2009): carvedilol vs PCB: ↓ACM, ↓HFH
Excluded: Cr>2.8 mg/dL
|
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COMET (2003): Carvedilol vs metoprolol low-dose: ↓ACM
No renal exclusion
|
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MRA | Enalapril | Excluded | RALES (1999): Spironolactone vs PCB: ↓ACM, ↓HFM, ↓SCD
Excluded: Cr>2.5 mg/dL
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Class | Medication | Dialysis | Cr 3.0-3.5 | Cr 2.5-3.0 | Cr 2.0-2.5 | Cr 1.0-2.0 |
Outcomes of HFrEF GDMT Trials
with eGFR-based renal exclusion criteria
Class | Medication | Dialysis | eGFR 0-15 | eGFR 15-30 | eGFR 30-45 | eGFR 45-60 | eGFR>60 |
---|---|---|---|---|---|---|---|
ARNI | Sacubitril-valsartan | Excluded | PARADIGM-HF (2014): sacubitril-valsartan vs enalapril: ↓CVM, ↓ACM, ↓HFH
Excluded: eGFR < 30
|
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MRA | Eplerenone | Excluded | EMPHASIS-HF (2001): Eplerenone vs PCB: ↓CVM, ↓HFH
Excluded: eGFR < 30
|
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SGLT2i | dapagliflozin | Excluded | DAPA-HF (2019): dapagliflozin vs PCB: ↓CVM, ↓ACM, ↓HFH
Excluded: eGFR < 30
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empgaliflozin | Excluded | EMPEROR-Reduced (2020): empagliflozin vs PCB: ↓HFH
Excluded: eGFR < 20
|
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sGC stimulator | Vericiguat | Excluded | VICTORIA (2020): vericiguat vs PCB: ↓CVM, ↓HFH
Excluded: eGFR < 15
|
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Myosin activators | omecantiv/mecarbil | Excluded | GALACTIC-HF (2021): omecantiv/mecarbil vs PCB: ↓CVM, ↓HFH
Excluded: eGFR < 15
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Class | Medication | Dialysis | eGFR 0-15 | eGFR 15-30 | eGFR 30-45 | eGFR 45-60 | eGFR>60 |
Outcomes of HFrEF GDMT Trials
that excluded renal patients on miscellaneous criteria
Class | Medication | "Kidney disease" | "No kidney disease" |
---|---|---|---|
BB | Carvedilol | Excluded | US Carvedilol (1996): carvedilol vs PCB: ↓CVH, ↓HFM
Excluded: "clinical important renal disease"
|
Excluded | CAPRICORN (2001): carvedilol vs PCB: ↓CVM, ↓ACM
Excluded: "renal impairment"
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IKi | Ivabradine | Excluded | SHIFT (2012): ivabradine vs PCB: ↓CVM, ↓HFH
Excluded: "severe renal disease"
|
Class | Medication | "Kidney disease" | "No kidney disease" |
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© Jiun-Ruey Hu, MD, MPH & Jiawei Tan, MD (2022)