Effects of serelaxin in acute heart failure patients with renal impairment: results from RELAX-AHF

Licette C.Y. Liu, Adriaan A. Voors, John R. Teerlink, Gad Cotter, Beth A. Davison, G. Michael Felker, Gerasimos Filippatos, Yakuan Chen, Barry H. Greenberg, Piotr Ponikowski, Peter S. Pang, Margaret F. Prescott, Tsushung A. Hua, Thomas M. Severin, Marco Metra

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Serelaxin showed beneficial effects on clinical outcome and trajectories of renal markers in patients with acute heart failure. We aimed to study the interaction between renal function and the treatment effect of serelaxin. Methods: In the current post hoc analysis of the RELAX-AHF trial, we included all patients with available estimated glomerular filtration rate (eGFR) at baseline (n = 1132). Renal impairment was defined as an eGFR <60 ml/min/1.73 m2 estimated by creatinine. Results: 817 (72.2 %) patients had a baseline eGFR <60 ml/min/1.73 m2. In placebo-treated patients, baseline renal impairment was related to a higher 180 day cardiovascular (HR 3.12, 95 % CI 1.33–7.30) and all-cause mortality (HR 2.81, 95 % CI 1.34–5.89). However, in serelaxin-treated patients, the risk of cardiovascular and all-cause mortality was less pronounced (HR 1.19, 95 % CI 0.54 –2.64; p for interaction = 0.106, and HR 1.15 95 % CI 0.56–2.34 respectively; p for interaction = 0.088). In patients with renal impairment, treatment with serelaxin resulted in a more pronounced all-cause mortality reduction (HR 0.53, 95 % CI 0.34–0.83), compared with patients without renal impairment (HR 1.30, 95 % CI 0.51–3.29). Conclusion: Renal dysfunction was associated with higher cardiovascular and all-cause mortality in placebo-treated patients, but not in serelaxin-treated patients. The observed reduction in (cardiovascular) mortality in RELAX-AHF was more pronounced in patients with renal dysfunction. These observations need to be confirmed in the ongoing RELAX-AHF-2 trial.

Original languageEnglish (US)
Pages (from-to)727-737
Number of pages11
JournalClinical Research in Cardiology
Issue number9
StatePublished - Sep 1 2016


  • Acute heart failure
  • Number needed to treat
  • Renal function
  • Renal impairment
  • Serelaxin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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