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Heart FailurePhase 4PRESENT-HFNCT05487261

Pulmonary REsistance Modification Under Treatment With Sacubitril/valsartaN in paTients With Heart Failure With Reduced Ejection Fraction

A Phase 4 study testing Sacubitril-valsartan and Enalapril in people with Heart Failure, run by Clinical Hospital Heliodor Swiecicki of the Medical University of Karol Marcinkowski in Poznań at 5 sites in Poland.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

MAIN OBJECTIVE. Demonstration that use of sacubitril/valsartan influences parameters of right heart catheterization, including pulmonary artery pressure, and provokes changes in pulmonary circulation resistance in patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and post-capillary… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Heart Failure
What is being tested?
Sacubitril-valsartan and Enalapril
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
260 participants
Where
5 sitesPoland
Study dates
13 Dec 2022to Nov 2025
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18 years of age who are able to complete and sign the informed consent form.
  • HF patients in NYHA functional class II-IV with a reduced left ventricular ejection fraction (LVEF) ≤40% -(HFrEF) (confirmed by an examination such as echocardiography or cardiac magnetic resonance within the last 6 months) in whom right heart catheterization (RHC) reveals post-capillary or mixed pulmonary hypertension (defined on the basis of the 2015 ESC (European Society of Cardiology) guidelines: mean pulmonary artery pressure (PAPm) ≥25 mmHg and pulmonary capillary wedge pressure (PCWP)>15mmHg) were found, both of the isolated extracapillary PH (Ipc-PH) (defined on the basis of the 2015 ESC guidelines: DPG < 7 mm Hg and / or PVR ≤ 3 WU) as well as complex extra-and pre-capillary PH (Cpc-PH) (defined on the basis of the 2015 ESC guidelines: DPG ≥ 7 mm Hg and / or PVR> 3 WU).
  • Stable patients haemodynamics, which is defined as no change in diuretic use for at least 4 weeks prior to study entry.
  • HF during optimal treatment with ACE-I (angiotensin converting enzyme) /ARB (angiotensin receptor blocker), beta blocker, MRA (Mineralocorticoid Receptor Antagonists), SGLT2-I except in cases where the above-mentioned treatment was contraindicated or not tolerated.
  • Understanding and acceptance of the research assumptions and methods and signing the informed consent by the patient.

Who cannot join

  • Current treatment with S/V.
  • Cardiogenic shock.
  • Current treatment with sildenafil.
  • Patients ineligible or contraindicated for treatment with sacubitril-valsartan.
  • Patients with a history of angioedema.
  • Patients who have had a heart transplant or have had a circulatory support device.
Show all 33Show fewer
  • Patient on the urgent list for heart transplant.
  • Isolated right HF secondary to lung disease.
  • Documented untreated significant ventricular arrhythmia with syncope within the previous 3 months.
  • Symptomatic bradycardia or second or third degree atrioventricular block not protected by a pacemaker.
  • Factors that prevent RHC testing (e.g. very serious condition of the patient that makes it impossible to lie down, cardiogenic shock, allergy to contrast agents, etc.).
  • Pregnant or lactating women.
  • Women of childbearing age, defined as the physiological possibility of becoming pregnant, unless using two methods of contraception.
  • Acute coronary syndrome, including myocardial infarction (STEMI, NSTEMI), a condition with carotid revascularization or major cardiovascular surgery in the last 30 days.
  • Stroke or transient cerebral ischemia (TIA) within the last 3 months.
  • Previous CRT (Cardiac Resynchronization Therapy) implantation in the last 3 months or planning for CRT implantation.
  • Life expectancy <6 months.
  • Severe renal failure, eGFR (epidermal growth factor receptor) <30 ml / min / 1.73 m2(calculated according to the MDRD formula).
  • Serum potassium> 5.2 mEq/L.
  • Liver failure or elevated liver transaminases (total bilirubin> 3 mg / dL and/or ALT (Aspartate transaminase) and/or AST (Aspartate Aminotransferase) ≥3x ULN).
  • A major surgery planned within 6 months of randomization.
  • Planned coronary angioplasty or pacemaker / ICD (implantable cardioverter defibrillator) / CRT implantation within the next 6 months.
  • Severe primary valve disease (NOT secondary mitral regurgitation) or obstructive hypertrophic cardiomyopathy.
  • The presence of a malignant neoplasm of any organ system, ie clinical signs or no stable remission for at least 3 years after the end of the last treatment, with the exception of non-invasive basal cell carcinoma, squamous cell carcinoma of the skin or cervical epithelial dysplasia.
  • Diseases that significantly reduce physical performance:
  • severe COPD (chronic obstructive pulmonary disease) putting off oxygen therapy,
  • severe asthma,
  • morbid obesity (BMI> 40 kg / m2),
  • significant lower limb atherosclerosis with intense intermittent claudication.
  • Uncontrolled hypertension (SBP> 170 mmHg and / or DBP> 100 mmHg).
  • Symptomatic hypotension (SPB <90 mmHg)
  • Any situation that may make it impossible to perform the research in accordance with the protocol or express written consent in the opinion of the researcher, including abuse of alcohol, drugs or other psychoactive substances.
  • Participation in a study with a device or medicinal product within 3 months prior to randomization or 5 half-lives, whichever is longer, prior to the screening visit.

Trial locations and contacts

5 sites in 1 country.

Marta Kałużna-Oleksy, MD, PhD contact

502 896 932 ext. 0048

marta.kaluzna@wp.pl

5 sites in 1 country

Poland5 sites, 5 recruiting
  • Medical University of Bialystok Clinical Hospital

    Bialystok, 15-276

    Agnieszka Tycińska, Prof. MD

    Agnieszka Tycińska, Prof. MD

    Not yet recruiting
  • University Clinical Centre in Gdańsk

    Gdansk, 80-952

    Marcin Gruchała, Prof. MD

    Marcin Gruchała, Prof. MD

    Not yet recruiting
  • University Clinical Hospital in Opole

    Opole, 45-401

    Marek Gierlotka, Prof. MD

    Marek Gierlotka, Prof. MD

    Not yet recruiting
  • University Hospital in Poznan

    Poznan, 61-848

    Ewa Straburzyńska-Migaj, Prof. MD, ewa.straburzynska-migaj@skpp.edu.pl

    Ewa Straburzyńska-Migaj, Prof. MD

    Recruiting
  • Specialist Hospital in Zabrze

    Zabrze, 41-800

    Ewa Nowalany-Kozielska, Prof. MD

    Ewa Nowalany-Kozielska, Prof. MD

    Not yet recruiting

Other trials in Poland

About this study

Official title: Pulmonary REsistance Modification Under Treatment With Sacubitril/valsartaN in paTients With Heart Failure With Reduced Ejection Fraction - PRESENT HF Study

MAIN OBJECTIVE. Demonstration that use of sacubitril/valsartan influences parameters of right heart catheterization, including pulmonary artery pressure, and provokes changes in pulmonary circulation resistance in patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and post-capillary pulmonary hypertension (PH): both isolated post-capillary (Ipc-PH) and combined post- and pre-capillary (Cpc-PH), which we predict could improve prognosis in this group of patients.

RESEARCH HYPOTHESIS. Sacubitril/valsartan used in patients with HFrEF accompanied by pulmonary hypertension due to HFrEF will reduce pulmonary artery pressure, pulmonary vascular resistance, and the incidence of secondary end-points as listed in the protocol.

STUDY OUTLINE. PRESENT-HF will show the effects of sacubitril/valsartan on pulmonary circulation pressure in patients with HFrEF and post-capillary pulmonary hypertension (PH): both isolated post-capillary (Ipc-PH) and combined post- and pre-capillary (Cpc-PH), which is expected to improve prognosis.

Read the detailed description

Non commercial, multicentre, randomised, double-blind, comparator-controlled clinical trial. Eligible patients were randomly assigned (1:1) using a secure, central, interactive, web-based response system, to intervention or comparator arm. Time of observation 13 months [1months active up titration phase + 12 months follow up].

Conditions
Heart Failure
Being tested
Sacubitril-valsartan, Enalapril, placebo
Medical subject headings
Heart Failure

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Sacubitril-valsartanDrug

    level 1-24 / 26mg 2 times a day, level 2-49 / 51mg 2 times a day, level 3-97 / 103mg 2 times aday

  • EnalaprilDrug

    level 1-2.5 mg twice a day, level 2-5 mg twice a day, level 3-10 mg twice a day

  • placeboDrug

    placebo matching for 24 / 26mg, 49 / 51mg, 97 / 103mg 2 of sacubitril/valsartan

  • PlaceboDrug

    placebo matching for 2.5 mg, 5 mg, 10 mg of enalapril

Study groups in NCT05487261
Study groupRoleWhat they receive
Sacubitril and valsartan combinationExperimentalPatient receive: 1 bottle with Sacubitril/Valsartan tablets and 2nd bottle with placebo to enalapril.
Receives: Drug: Sacubitril-valsartan; Drug: Placebo
EnalaprilActive comparatorPatient receive: 1 bottle with placebo to Sacubitril/Valsartan and 2nd bottle with enalapril.
Receives: Drug: Enalapril; Drug: placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. mean pulmonary artery pressure

    change from baseline in mean pulmonary artery pressure (mPAP), measured invasively in Right Heart Catheterization (RHC)

    Measured: 0-13 month

  2. pulmonary vascular resistance

    change from baseline in pulmonary vascular resistance (PVR), calculated from data measured invasively in Right Heart Catheterization (RHC)

    Measured: 0-13 month

Secondary outcomes (14)
  1. pulmonary wedge pressure

    change from baseline in pulmonary wedge pressure (PWP), measured invasively in Right Heart Catheterization (RHC)

    Measured: 0 -13 month

  2. diastolic pressure gradient

    change from baseline in the diastolic pressure gradient (DPG; where DPG = diastolic mPAP -mean PWP)

    Measured: 0-13 month

  3. 6-minute walk test

    change in the 6-minute walk test (6MWT) - analysis of changes from the baseline

    Measured: 0-13 month

  4. spiroergometric test (CPET, Cardio-Pulmonary Exercise Test)

    evaluation of the parameters of the spiroergometric test - analysis of changes in relation to the baseline

    Measured: 0-13 month

  5. echocardiographic parameters

    assessment of echocardiographic parameters - analysis of changes in echocardiographic parameters assessed in transthoracic echocardiographic examination (TTE)

    Measured: 0-13 month

  6. composite endpoint of MACCEs (major adverse cardiac and cerebrovascular events)

    The incidence of the composite endpoint of MACCEs such as death from all causes, cardiac death, hospitalization due to worsening/ decompensation of heart failure (HF), stroke/ transient ischemic attack (TIA), acute coronary syndrome (ACS), the need for a heart transplant (HT), the need for a left ventricular assist device (LVAD) or biventricular(BVAD)

    Measured: 0-13 month

  7. hospitalization or an unplanned visit to the Emergency Department

    hospitalization or an unplanned visit to the Emergency Department or an unplanned outpatient visit related to HF

    Measured: 0-13 month

  8. unplanned intravenous administration of diuretics and/or an unplanned hospitalization

    the need for unplanned intravenous administration of diuretics and/or an unplanned hospitalization, outpatient visit due to the need to administer intravenous diuretics or requiring an increase in the dose of diuretics >50% from baseline

    Measured: 0-13 month

  9. quality of life measurements - Short Form 36 Health Survey (SF-36 questionnaire)

    assessment of quality of life - SF-36 questionnaire - change from the baseline, the minimum and maximum values: 0-100, higher scores mean a less disability.

    Measured: 0-13 month

  10. quality of life measurements - Kansas City Cardiomyopathy Questionnaire (KCCQ)

    assessment of quality of life - KCCQ, the minimum and maximum values: 0-100, higher scores mean higher quality of life.

    Measured: 0-13 month

  11. quality of life measurements - EuroQol-5 Dimensions-3 Level (EQ-5D-3L) questionnaire

    assessment of quality of life - EQ-5D-3L questionnaire - change from the baseline, the minimum and maximum values: 0-100, higher scores mean higher quality of life.

    Measured: 0-13 month

  12. quality of life measurements - The World Health Organization Quality of Life (WHOQOL)

    assessment of quality of life - WHOQOL - change from the baseline, the minimum and maximum values: 0-100, higher scores mean higher quality of life.

    Measured: 0-13 month

  13. the New York Heart Association functional classes

    assessment of the New York Heart Association (NYHA) functional classes - change from the baseline, the minimum and maximum values: 1-4, higher scores mean a worse outcome.

    Measured: 0-13 month

  14. the World Health Organization functional classes

    assessment of the World Health Organization (WHO) functional classes - change from the baseline, the minimum and maximum values: 1-4, higher scores mean a worse outcome.

    Measured: 0-13 month

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Aug 2022
  2. Study start13 Dec 2022
  3. Primary completionFeb 2025 (estimated)
  4. Study completionNov 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
260 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05487261
Sponsor's protocol ID
2019/ABM/01/00078
Acronym
PRESENT-HF
Status last verified
Jun 2023
First submitted
26 Jul 2022
Last updated
18 Jun 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Sacubitril-valsartan and Enalapril in people with Heart Failure, run by Clinical Hospital Heliodor Swiecicki of the Medical University of Karol Marcinkowski in Poznań at 5 sites in Poland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 33 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 18 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in Poland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Marta Kałużna-Oleksy, MD, PhD (502 896 932 ext. 0048, marta.kaluzna@wp.pl), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

mean pulmonary artery pressure (time frame: 0-13 month). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Jun 2023.

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