Analysis of Clinical Application of Angiotensin Receptor Enkephalinase Inhibitor Sacubitril Valsartan in 61 Patients with Heart Failure / 中国药房

ABSTRACT

OBJECTIVE： To investigate the clinical application of angiotensin receptor enkephalinase inhibitor sacubitril valsartan in patients with heart failure， and to provide reference for its standardized use. METHODS： The electronic medical records of inpatients with heart failure using sacubitril valsartan in cardiovascular medicine department of the First Affiliated Hospital of Soochow University were collected from hospital information system during Oct. 2017 to Jun. 2018. Those medical records were analyzed statistically in respects of indication， contraindications， usage and dosage， conversion with angiotensin converting enzyme inhibitor （ACEI） or angiotensin Ⅱ receptor antagonist （ARB）， ADR and standard-reaching rate of target dose， etc. RESULTS： A total of 61 patients were given sacubitril valsartan， among which there were 7 cases （11.48％） without indication and 5 cases （8.20％） with contraindications. There were 34 cases （55.74％） with unreasonable initial dose， 4 cases （6.56％） with unreasonable frequency， 7 cases （11.48％） with unreasonable conversion with ACEI， 2 cases （3.28％） with unreasonable conversion with ARB. 9 cases （14.75％） suffered from ADR. All patients did not reach the target dose， but 27 patients （44.26％） met the target blood pressure. CONCLUSIONS： There is still a certain gap between clinical application of sacubitril valsartan and 2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure and 2017 Guideline for the Management of Heart Failure， mainly involving indication， contraindications， usage and dosage， drug conversion， etc. Specially the initial dosage is generally low. It is suggested that its clinical application should be further standardized by means of real-time checking and regular evaluation.