Efficacy and Safety of LCZ696 Compared to Valsartan on Cognitive Function in Patients With Chronic Heart Failure and Preserved Ejection Fraction (PERSPECTIVE)
Chronic Heart Failure (CHF)
About this trial
This is an interventional treatment trial for Chronic Heart Failure (CHF) focused on measuring heart failure, cognition, positron emission tomography, magnetic resonance imaging, LCZ696, valsartan, Chronic heart failure, CHF
Eligibility Criteria
Key Inclusion Criteria:
- Chronic heart failure with current symptoms NYHA class II-IV
- Left ventricular ejection fraction > 40%
- NT-proBNP >= 125 pg/mL at screening visit
- Patient with evidence of adequate functioning to complete study assessments
Key Exclusion Criteria:
- Patients with acute decompensated heart failure requiring augmented therapy with diuretics, vasodilators and/or inotropic drugs
- Acute coronary syndrome (including myocardial infarction (MI)), cardiac surgery, other major CV surgery, or urgent percutaneous coronary intervention (PCI), carotid surgery or carotid angioplasty, history of stroke or transient ischemic attack within the 3 months prior to Screening visit or an elective PCI within 30 days prior to Screening visit
- Patients with history of hereditary or idiopathic angioedema or angioedema related to previous ACEi or ARB therapies
- Patients who require treatment with 2 or more of the following: an ACEi, an ARB or a renin inhibitor
Patients with one of the following:
- Patients with serum potassium >5.2 mmol/L (mEq/L) at Screening visit
- Patients with serum potassium >5.4 mmol/L (mEq/L) at any visit during run-in treatment period or at randomization visit
- Systolic blood pressure (SBP) ≥180 mmHg at Screening visit, or
- SBP <110 mmHg at Screening visit, or
- SBP <100 mmHg or symptomatic hypotension as determined by the investigator at Visit 103 or at randomization visit
- Body mass index (BMI) >45 kg/m^2
Patients with
- known pericardial constriction, genetic hypertrophic cardiomyopathy, infiltrative cardiomyopathy
- hemodynamically significant obstructive valvular disease
- Life-threatening or uncontrolled dysrhythmia, including symptomatic or sustained ventricular tachycardia and atrial fibrillation or flutter with a resting ventricular rate >110 beats per minute
- Inability to perform cognitive battery or other study evaluations based on significant motor (e.g. hemiplegia, muscular-skeletal injury) or sensory (blindness, decreased or uncorrected visual or auditory acuity) skill
- Clinically significant cerebral pathology for example large cerebral aneurysm or space occupying lesion that may impact cognition as assessed by central MRI reader
- Mini mental state examination score less than 24 at screening
- Patients with a clinical diagnosis of Alzheimer's disease or other dementia syndromes or any indication for or current treatment with cholinesterase inhibitors and/or another prescription AD treatment (e.g. memantine).
Sites / Locations
- Novartis Investigative Site
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Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
LCZ696
Valsartan
Patients will receive LCZ696 at 100 mg twice daily during a single-blind treatment run-in period to ensure patients tolerate this medication before they are randomized. Down-titration is not allowed during this period. Patients who are able to tolerate LCZ696 100 mg twice daily are eligible to enter the randomized treatment period. Patients randomized to receive LCZ696 will be given LCZ696 at 200 mg twice daily. Patients will receive randomized study drug for three years.
Patients will receive valsartan at 40mg and/or 80mg twice daily during a single-blind treatment run-in period. Following the run-in period, patients randomized to receive valsartan will be given valsartan at 160 mg twice daily for three years.