TY  - JOUR
AB  - Background: Currently, data on sacubitril/valsartan therapy from the real-world settings are scarce and the predictors of a good clinical responsiveness to this drug are unknown. Objectives: To assess efficacy and safety profile of sacubitril/valsartan and to identify predictors for a better clinical outcome. Materials and methods: Clinical, laboratory and echocardiographic data of 95 chronic heart failure (CHF) patients with reduced ejection fraction (HFrEF) were retrospectively analyzed. A good efficacy of sacubitril/valsartan was defined as the fulfilment of at least 2 of the following criteria: improvement of left ventricular ejection fraction (LVEF) or functional status, and reduction of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels or hospitalization rates. Results: Under sacubitril/valsartan, major improvements were observed in LVEF, the New York Heart Association (NYHA) class, NT-proBNP levels, and hospitalization rates. Patients with a good efficacy of sacubitril/valsartan were characterized by initially worse LVEF (median (interquartile range (IQR)): 29.0% (23.0–33.0%) compared to 32.0% (28.5–38.0%) with more frequent nonischemic etiology (65.4% compared to 41.9%) and hospitalizations for CHF/month (0.016 (0.004–0.057) compared to 0.000 (0.000–0.012)), lower cholesterol (42.3% compared to 65.1%), higher C-reactive protein (CRP) levels at baseline (0.5 mg/L (0.5–1.0 mg/L) compared to 0.5 mg/L (0.5–0.5 mg/L)), and a shorter timespan between CHF diagnosis and the start of sacubitril/valsartan treatment (66.0 (11.0–127.0) compared to 111 (73.0–211.0) months) (p < 0.05 each). In a multivariate Cox analysis, only the last 2 parameters were shown to be independent predictors of good clinical responsiveness to sacubitril/valsartan (hazard ratio (HR) = 1.263, 95% confidence interval (95% CI) = [1.048; 1.521]; HR = 0.992, 95% CI = [0.987; 0.997], p < 0.05, respectively). Conclusions: Sacubitril/valsartan improved LVEF, NYHA class, NT-proBNP levels, and hospitalization rates, mostly without relevant side effects. The independent predictors of a good clinical efficacy were higher CRP levels at baseline and a shorter delay between CHF diagnosis and the initialization of sacubitril/valsartan therapy.
AU  - Fröb, Elisabeth J.
AU  - Sindermann, Jürgen
AU  - Reinecke, Holger
AU  - Tuleta, Izabela
DA  - 2022-01-29
DO  - 10.17879/32029706419
KW  - CRP
KW  - Sacubitril/valsartan
KW  - NYHA class
KW  - Chronic heart failure with reduced left ventricular ejection fraction
KW  - Hospitalization rates
LA  - eng
N1  - Adv Clin Exp Med. 31 (2022) 5, 475-487
N1  - Finanziert durch den Open-Access-Publikationsfonds der Westfälischen Wilhelms-Universität Münster (WWU Münster).
PY  - 2022-01-29
TI  - Efficacy and safety of sacubitril/valsartan in an outpatient setting: A single-center real-world retrospective study in HFrEF patients with focus on possible predictors of clinical outcome
UR  - https://nbn-resolving.org/urn:nbn:de:hbz:6-32029528456
Y2  - 2024-11-22T02:19:08
ER  -