Sacubitril in HF (PARADIGM-HF) vs Sudden Cardiac Death in ESRD
Winner: Sudden Cardiac Death in ESRD
PARADIGM-HF represents a potential game changer for the management of chronic heart failure. There is also hope for the treatment of chronic kidney disease. However, these studies are currently ongoing. The blue-ribbon panel (BRP) just couldn’t let such a novel therapy advance on and went with Team Sudden Cardiac Death in ESRD for the win in a 5-2 decision. Here are a few comments from the panel: “While the PARADIGM-HF is interesting and useful, sudden cardiac death in ESRD plagues us. Experience will wear down the upstarts in this one.” Even though Team PARADIGM-HF holds tons of promise, some issues have been pointed out with the trial design. In particular the use of an ACEi as a comparator instead of an ARB.
Sodium Restriction for CHF vs Statins in ESRD
Winner: Sodium Restriction for CHF
In a convincing 7-0 vote, Team Sodium Restriction in CHF beats Team Statin in ESRD. Seems like the Statins were discontinued after a very tough battle against Team Warfarin in ESRD. Team Statin continues to take a beating from twitter.
However, it hasn’t all been rosy for Team Sodium Restriction either.
Even with the lack of clear cut evidence, the sodium restriction in CHF literature is littered with contradictory findings. Team Sodium Restriction moves on to face Team Sudden Cardiac Death in ESRD in a Heart and Kidney Connection regional final. Might as well start the #BlueRibbonAirBall hashtag now.