Table I.

Summary of trials

Trial	Study arms	Acuity of treatment	Patient population	Primary end point	Results
RELAX-AHF (n = 1161)	Seralaxin 30 μg kg−1 d−1 vs placebo for 48 h	Randomization within 16 h of hospital arrival	Patients with dyspnea at rest or minimal exertion, congestion on chest x-ray, BNP ≥350 ng/L, eGFR 30–75 mL/min per 1.73 m2, and SBP >125 mm Hg	Change in patient-reported dyspnea from baseline to day 5 (VAS AUC) Moderately or markedly improved patient-reported dyspnea at 6, 12, and 24 h (7-point Likert scale)	Seralaxin significantly improved dyspnea compared with placebo by VAS AUC (P = .007) No difference between dyspnea improvement by Likert (P = .70)
ASTRONAUT (n = 1639 randomized; 1615 in final efficacy analysis)	Aliskiren 150 mg daily (increased to 300 mg as tolerated) vs placebo	After a period of stabilization (median 5 d after admission)	Hemodynamically stable patients hospitalized for HF with EF ≤40%, BNP ≥400 pg/mL or NT-proBNP ≥1600 pg/mL, and signs/symptoms of fluid overload	CV death or HF rehospitalization at 6 and 12 mo	No difference in CV death or HF hospitalization at 6 (P = .41) or 12 mo (P = .36)
PRONTO (n=104)	Clevidipine vs standard-of-care IV antihypertensives	Emergency department: door-to-treatment time of 149 mo (104, 219)	Dyspneic patients with acute HF with SBP ≥160 mm Hg	Median time and percent of patients that attain the initial prespecified SBP target range and a 15% reduction in SBP from baseline within the first 30 minutes	More patients reached the target SBP range and a 15% SBP reduction with clevidipine vs usual care (P = .0006)

Abbreviations: eGFR, Estimated glomerular filtration rate; AUC, area under the curve; CV, cardiovascular.