
In the SERENADE trial, macitentan was tested in 142 patients with heart failure (HF) and preserved ejection fraction (≥40%) and pulmonary vascular disease. Despite its favorable hemodynamic effects, macitentan did not reduce NT-proBNP levels (geometric mean ratio 1.02; P = 0.79) or improve secondary outcomes like the KCCQ score. More patients treated with macitentan experienced fluid retention (23% vs. 14%) and cardiac adverse events (46% vs. 31%), with no significant improvement in HF outcomes.
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