title: Serelaxin in acute heart failure patients with preserved left ventricular ejection fraction: results from the RELAX-AHF trial.
abstract: OBJECTIVE
  Serelaxin is effective in relieving dyspnoea and improving multiple outcomes in acute heart failure (AHF). Many AHF patients have preserved ejection fraction (HFpEF). Given the lack of evidence-based therapies in this population, we evaluated the effects of serelaxin according to EF in RELAX-AHF trial.
  
  
  RESULTS
  RELAX-AHF randomized 1161 AHF patients to 48-h serelaxin (30 μg/kg/day) or placebo within 16 h from presentation. We compared the effects of serelaxin on efficacy endpoints, safety endpoints, and biomarkers of organ damage between preserved (≥50%) and reduced (<50%, HFrEF) EF. HFpEF was present in 26% of patients. Serelaxin induced a similar dyspnoea relief in HFpEF vs. HFrEF patients by visual analogue scale-area under the curve (VAS-AUC) through Day 5 [mean change, 461 (-195, 1117) vs. 397 (10, 783) mm h, P = 0.87], but had possibly different effects on the proportion of patients with moderately or markedly dyspnoea improvement by Likert scale at 6, 12, and 24 h [odds ratio for favourable response, 1.70 (0.98, 2.95) vs. 0.85 (0.62, 1.15), interaction P = 0.030]. No differences were encountered in the effect of serelaxin on short- or long-term outcome between HFpEF and HFrEF patients including cardiovascular death or hospitalization for heart/renal failure through Day 60, cardiovascular death through Day 180, and all-cause death through Day 180. Similar safety and changes in biomarkers (high-sensitivity troponin T, cystatin-C, and alanine/aspartate aminotransferases) were found in both groups.
  
  
  CONCLUSIONS
  In AHF patients with HFpEF compared with those with HFrEF, serelaxin was well tolerated and effective in relieving dyspnoea and had a similar effect on short- and long-term outcome, including survival improvement.
authors: Athens University Hospital Attikon, Athens, Greece.
authors: Gerasimos
authors: G
authors: Filippatos
authors: John R
authors: JR
authors: Teerlink
authors: Dimitrios
authors: D
authors: Farmakis
authors: Gad
authors: G
authors: Cotter
authors: Beth A
authors: BA
authors: Davison
authors: G Michael
authors: GM
authors: Felker
authors: Barry H
authors: BH
authors: Greenberg
authors: Tsushung
authors: T
authors: Hua
authors: Piotr
authors: P
authors: Ponikowski
authors: Thomas
authors: T
authors: Severin
authors: Elaine
authors: E
authors: Unemori
authors: Adriaan A
authors: AA
authors: Voors
authors: Marco
authors: M
authors: Metra
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000378:metabolism; D002316:Cardiotonic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012065:Relaxin / Q000008:administration & dosage* / Q000009:adverse effects; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D015415:Biomarkers; D002316:Cardiotonic Agents; D011994:Recombinant Proteins; C577649:serelaxin protein, human; D012065:Relaxin
keywords: Acute heart failure; Diastolic heart failure; Dyspnoea; Heart failure with preserved left ventricular ejection fraction; Relaxin; Serelaxin