GALACTIC-HF: Omecamtiv mecarbil option for HFrEF patients with low SBP

Although patients with heart failure and reduced ejection fraction (HFrEF) and low systolic blood pressure (SBP) displayed a higher risk of HF outcomes in a subanalysis of the GALACTIC-HF trial, treatment with omecamtiv mecarbil reduced this risk more distinctively than in those with a higher SBP. Since placebo and omecamtiv mecarbil showed similar safety profiles, this agent may be a valid option for the hard-to-treat population of patients with HFrEF and low SBP.

“Patients with HFrEF and low SBP are at increased risk of clinical events and do not tolerate guideline-directed medical therapy well,” explained Prof. Marco Metra (University of Brescia, Italy) [1]. “Omecamtiv mecarbil is a selective cardiac myosin activator that improves cardiac function, without reducing blood pressure.” Therefore, this agent may be useful in these patients. Prof. Metra and colleagues analysed the efficacy and safety of omecamtiv mecarbil in patients with HFrEF and low SBP (≤100 mmHg) who were enrolled in the GALACTIC-HF trial (NCT02929329; total n=8,232; low SBP n=1,473). The primary analysis of this trial showed a significant benefit of omecamtiv mecarbil over placebo in time to first HF event or cardiovascular death in the overall population (HR 0.92; P=0.025) [2].

The current subanalysis showed that patients with a low SBP had a higher risk of HF events than patients with an SBP >100 mmHg  (HR 1.05 per 5 mmHg; P<0.001). However, the treatment effect of omecamtiv mecarbil on cardiovascular death or time to first HF event was numerically larger in those with a low SBP (HR 0.81) than in those with a higher SBP (HR 0.95; P_interaction=0.051). Furthermore, the safety profiles of omecamtiv mecarbil and placebo were similar in both SBP groups. Thus, the authors concluded that the challenging population of patients with HFrEF and low SBP may benefit from treatment with omecamtiv mecarbil.

1. 
   
   1. Metra M, et al. GALACTIC-HF - omecamtiv mecarbil in HFrEF and low blood pressure. LBT 1, Heart Failure 2022, 21–24 May, Madrid, Spain.
   
   
   2. Teerlink JR, et al. JACC Heart Fail. 2020;8:329–340.

 

Copyright ©2021 Medicom Medical Publishers





Posted on 23 May, 202213 June, 2022