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Sci Rep ; 10(1): 6665, 2020 04 20.
Article in English | MEDLINE | ID: mdl-32313194

ABSTRACT

The aim of this study was to evaluate the effects of Sacubitril/Valsartan (S/V) on clinical, laboratory and echocardiographic parameters and outcomes in a real-world population with heart failure with reduced ejection fraction (HFrEF). This was a prospective observational study enrolling patients with HFrEF undergoing treatment with S/V. The primary outcome was the composite of cardiac death and HF rehospitalization at 12 months follow-up; secondary outcomes were all-cause death, cardiac death and the occurrence of rehospitalization for worsening HF. The clinical outcome was compared with a retrospective cohort of 90 HFrEF patients treated with standard medical therapy. The study included 90 patients (66.1 ± 11.7 years) treated with S/V. The adjusted regression analysis showed a significantly lower risk for the primary outcome (HR:0.31; 95%CI, 0.11-0.83; p = 0.019) and for HF rehospitalization (HR:0.27; 95%CI, 0.08-0.94; p = 0.039) in S/V patients as compared to the control group. A significant improvement in NYHA class, left ventricular ejection fraction, left ventricular end systolic volume and systolic pulmonary arterial pressure was observed up to 6 months. S/V did not affect negatively renal function and was associated with a significantly lower dose of furosemide dose prescribed at 6- and 12-month follow-up. In this study, S/V reduced the risk of HF rehospitalization and cardiac death at 1 year in patients with HFrEF. S/V improved NYHA class, echocardiographic parameters and need of furosemide, and preserved renal function.


Subject(s)
Aminobutyrates/therapeutic use , Angiotensin Receptor Antagonists/therapeutic use , Cardiotonic Agents/therapeutic use , Heart Failure/drug therapy , Heart/drug effects , Tetrazoles/therapeutic use , Ventricular Dysfunction, Left/drug therapy , Aged , Arterial Pressure/drug effects , Biphenyl Compounds , Case-Control Studies , Diuretics/therapeutic use , Drug Combinations , Echocardiography , Female , Furosemide/therapeutic use , Heart/diagnostic imaging , Heart/physiopathology , Heart Failure/metabolism , Heart Failure/mortality , Heart Failure/physiopathology , Humans , Kidney/drug effects , Kidney/metabolism , Kidney/physiopathology , Kidney Function Tests , Male , Middle Aged , Patient Readmission/statistics & numerical data , Regression Analysis , Retrospective Studies , Stroke Volume/drug effects , Survival Analysis , Treatment Outcome , Valsartan , Ventricular Dysfunction, Left/metabolism , Ventricular Dysfunction, Left/physiopathology
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