Sacubitril/valsartan for heart failure with reduced left ventricular ejection fraction View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-01-19

AUTHORS

R. De Vecchis, C. Ariano, G. Di Biase, M. Noutsias

ABSTRACT

BackgroundThe combination drug sacubitril/valsartan was reported to be superior to enalapril in reducing all-cause death, cardiovascular mortality, and heart failure (HF) hospitalizations in patients with cardiac insufficiency and reduced left ventricular ejection fraction (HFREF) with NYHA class II–IV.MethodsOur retrospective cohort study aimed to assess the effects of sacubitril/valsartan in addition to a beta-blocker and mineral receptor antagonist (MRA) in a group of HFREF patients with NYHA class II–III HF vs. conventional therapy (ACE inhibitor or angiotensin II receptor blocker added to a beta-blocker plus an MRA) administered to a control group of HFREF patients with comparable clinical features. In both groups, treatment was supplemented by a loop diuretic, usually furosemide, at variable doses. The primary outcomes were all-cause death and HF hospitalizations. Safety outcomes were symptomatic hypotension, angioedema, hyperkalemia, and worsening renal function.ResultsMortality at 6 months was 6.8% in patients taking sacubitril/valsartan vs. 34% in those on conventional therapy (odds ratio [OR] = 0.14; 95% CI: 0.04–0.49). Moreover, there was a 4.5% rate of HF hospitalizations in the sacubitril/valsartan group vs. 59% in the control group (OR = 0.03; 95% CI: 0.01–0.14). Safety outcomes were comparable in the two groups, although hypotension (systolic blood pressure < 100 mm Hg) was found in 15.9% of patients in the sacubitril/valsartan group vs. 5.7% in the control group (OR = 3.14; 95% CI: 0.94–10.55).ConclusionSacubitril/valsartan offered strong protection against all-cause death and HF hospitalizations at 6 months without any significant side effects. To validate this efficacious molecule, further postmarketing observational studies, focusing mainly on hypotension and angioedema are warranted. More... »

PAGES

425-432

References to SciGraph publications

  • 2013-04-17. Natriuretic peptide-guided therapy in HERZ
  • 2017-09-22. Acute heart failure in HERZ
  • 2017-03-09. Potential Expanded Indications for Neprilysin Inhibitors in CURRENT HEART FAILURE REPORTS
  • 2016-12-22. Sacubitril/Valsartan (LCZ696) in Heart Failure in HEART FAILURE
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    http://scigraph.springernature.com/pub.10.1007/s00059-017-4671-1

    DOI

    http://dx.doi.org/10.1007/s00059-017-4671-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1100478773

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29350254


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