Serelaxin in acute heart failure patients with and without atrial fibrillation: a secondary analysis of the RELAX-AHF trial

Gerasimos Filippatos, Dimitrios Farmakis, Marco Metra, Gad Cotter, Beth A. Davison, G. Michael Felker, Barry H. Greenberg, Tsushung A. Hua, Peter S. Pang, Piotr Ponikowski, Min Qian, Thomas A. Severin, Adriaan A. Voors, John R. Teerlink

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Background: Atrial fibrillation (AFib) is a common comorbidity in HF and affects patients’ outcome. We sought to assess the effects of serelaxin in patients with and without AFib. Methods: In a post hoc analysis of the RELAX-AHF trial, we compared the effects of serelaxin on efficacy end points, safety end points and biomarkers in 1161 patients with and without AFib on admission electrocardiogram. Results: AFib was present in 41.3% of patients. Serelaxin had a similar effect in patients with and without AFib, including dyspnea relief by visual analog scale through day 5 [mean change in area under the curve, 541.11 (33.79, 1048.44), p = 0.0366 in AFib versus 361.80 (−63.30, 786.90), p = 0.0953 in non-AFib, interaction p = 0.5954] and all-cause death through day 180 [HR = 0.42 (0.23, 0.77), p = 0.0051 in AFib versus 0.90 (0.53, 1.52), p = 0.6888 in non-AFib, interaction p = 0.0643]. Serelaxin was similarly safe in the two groups and induced similar reductions in biomarkers of cardiac, renal and hepatic damage. Stroke occurred more frequently in AFib patients (2.8 vs. 0.8%, p = 0.0116) and there was a trend for lower stroke incidence in the serelaxin arm in AFib patients (odds ratios, 0.31, p = 0.0759 versus 3.88, p = 0.2255 in non-AFib, interaction p = 0.0518). Conclusions: Serelaxin was similarly safe and efficacious in improving short- and long-term outcomes and inducing organ protection in acute HF patients with and without AFib.

Original languageEnglish (US)
Pages (from-to)444-456
Number of pages13
JournalClinical Research in Cardiology
Volume106
Issue number6
DOIs
StatePublished - Jun 1 2017

Keywords

  • Acute heart failure
  • Atrial fibrillation
  • Relaxin
  • Serelaxin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Filippatos, G., Farmakis, D., Metra, M., Cotter, G., Davison, B. A., Felker, G. M., Greenberg, B. H., Hua, T. A., Pang, P. S., Ponikowski, P., Qian, M., Severin, T. A., Voors, A. A., & Teerlink, J. R. (2017). Serelaxin in acute heart failure patients with and without atrial fibrillation: a secondary analysis of the RELAX-AHF trial. Clinical Research in Cardiology, 106(6), 444-456. https://doi.org/10.1007/s00392-016-1074-x