
Macitentan did not improve heart failure outcomes despite targeted trial design. The SERENADE trial (n=142) tested macitentan in HF patients with LVEF ≥40% and pulmonary vascular disease. Macitentan failed to reduce NT-proBNP (P=0.79) or improve symptoms. More patients experienced fluid retention (23% vs. 14%) and cardiac adverse events (46% vs. 31%). Findings suggest endothelin receptor antagonists remain ineffective for HF management.
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