PMID- 29909743
OWN - NLM
STAT- MEDLINE
DCOM- 20190827
LR  - 20211204
IS  - 1784-973X (Electronic)
IS  - 0001-5385 (Linking)
VI  - 74
IP  - 2
DP  - 2019 Apr
TI  - Impact of sacubitril/valsartan on heart failure admissions: insights from 
      real-world patient prescriptions.
PG  - 115-122
LID - 10.1080/00015385.2018.1473825 [doi]
AB  - BACKGROUND: Sacubitril/valsartan reduced heart failure (HF)-admissions and 
      cardiovascular mortality in the PARADIGM-HF-trial. However, real-world patients 
      are often frailer and less able to tolerate high doses of sacubitril/valsartan. 
      METHODS: We performed a retrospective analysis of consecutive patients prescribed 
      sacubitril/valsartan in a single tertiary HF-clinic between December 2016 and 
      January 2018. HF-admissions were assessed in a paired fashion, comparing the 
      amount of antecedent HF-episodes with incident HF-episodes after the initiation. 
      Baseline risk for adverse events was assessed by the EMPHASIS-HF-risk-score. 
      RESULTS: A total of 201-HF-patients were retrospectively identified 
      (age = 68 +/- 11 years, ejection fraction = 29 +/- 8%). Real world patients were 
      older, had higher serum creatinine and a higher New-York Heart-Association 
      (NYHA)-class (p < .05 for all) than in the PARADIGM-HF trial. Over a mean 
      duration of 221 +/- 114 days after initiation of sacubitril/valsartan a total of 
      23-individual patients experienced at least one HF-episodes. Over the same time 
      period preceding initiation of sacubitril/valsartan, 51 individual patients 
      experienced a HF-episodes (p < .001). Sacubitril/valsartan significantly reduced 
      the rate of incident vs. antecedent HF-admissions, in patients with low or high 
      baseline NYHA-class (II vs. III and IV; p value = 0.019 respectively p = .004) or 
      patients with an EMPHASIS-HF risk score below or above the mean (p = .002 
      respectively p = .016). Patients older than 75-years exhibited a trend towards 
      HF-reduction. Higher doses of sacubitril/valsartan were associated with more 
      reduction in incident versus antecedent HF-episodes. CONCLUSION: Despite being 
      frailer and older, real-world patients exhibit a significant and early reduction 
      in incident HF-hospitalisations following initiation of sacubitril/valsartan. 
      Higher doses might be associated with more reduction in HF-admissions, 
      underscoring the importance of dose uptitration.
FAU - Martens, Pieter
AU  - Martens P
AD  - a Department of Cardiology , Ziekenhuis Oost-Limburg , Genk , Belgium.
AD  - b Doctoral School for Medicine and Life Sciences , Hasselt University , 
      Diepenbeek , Belgium.
FAU - Lambeets, Seppe
AU  - Lambeets S
AD  - a Department of Cardiology , Ziekenhuis Oost-Limburg , Genk , Belgium.
FAU - Lau, Chirik Wah
AU  - Lau CW
AD  - a Department of Cardiology , Ziekenhuis Oost-Limburg , Genk , Belgium.
FAU - Dupont, Matthias
AU  - Dupont M
AD  - a Department of Cardiology , Ziekenhuis Oost-Limburg , Genk , Belgium.
FAU - Mullens, Wilfried
AU  - Mullens W
AD  - a Department of Cardiology , Ziekenhuis Oost-Limburg , Genk , Belgium.
AD  - c Biomedical Research Institute, Faculty of Medicine and Life Sciences , Hasselt 
      University , Diepenbeek , Belgium.
LA  - eng
PT  - Journal Article
DEP - 20180617
PL  - England
TA  - Acta Cardiol
JT  - Acta cardiologica
JID - 0370570
RN  - 0 (Aminobutyrates)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Biphenyl Compounds)
RN  - 0 (Drug Combinations)
RN  - 0 (Tetrazoles)
RN  - 80M03YXJ7I (Valsartan)
RN  - WB8FT61183 (sacubitril and valsartan sodium hydrate drug combination)
SB  - IM
EIN - Acta Cardiol. 2019 Aug;74(4):367. PMID: 30328787
MH  - Aged
MH  - Aminobutyrates/*therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Belgium/epidemiology
MH  - Biphenyl Compounds
MH  - Drug Combinations
MH  - Drug Prescriptions/*statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*drug therapy/epidemiology/physiopathology
MH  - Hospitalization/*trends
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Retrospective Studies
MH  - Stroke Volume/*physiology
MH  - Survival Rate/trends
MH  - Tetrazoles/*therapeutic use
MH  - Treatment Outcome
MH  - Valsartan/*therapeutic use
OTO - NOTNLM
OT  - Sacubitril/valsartan
OT  - heart failure
OT  - hospitalizations
OT  - pharmacology
EDAT- 2018/06/19 06:00
MHDA- 2019/08/28 06:00
CRDT- 2018/06/19 06:00
PHST- 2018/06/19 06:00 [pubmed]
PHST- 2019/08/28 06:00 [medline]
PHST- 2018/06/19 06:00 [entrez]
AID - 10.1080/00015385.2018.1473825 [doi]
PST - ppublish
SO  - Acta Cardiol. 2019 Apr;74(2):115-122. doi: 10.1080/00015385.2018.1473825. Epub 
      2018 Jun 17.