PMID- 35027945
OWN - NLM
STAT- MEDLINE
DCOM- 20220117
LR  - 20220430
IS  - 1752-8976 (Electronic)
IS  - 1470-3203 (Print)
IS  - 1470-3203 (Linking)
VI  - 2021
DP  - 2021
TI  - Long-Term Mortality and Morbidity Related to Congestive Heart Failure with 
      Reduced Ejection Fraction (CHFrEF) in Palestinian Patients Maintained on 
      Submaximal Sacubitril/Valsartan Doses: A Pilot Study.
PG  - 1829873
LID - 10.1155/2021/1829873 [doi]
LID - 1829873
AB  - BACKGROUND: The efficacy of sacubitril/valsartan, a newly introduced combination 
      drug for heart failure with reduced ejection fraction (HFrEF), was demonstrated 
      in the PARADIGM-HF trial conducted in Western countries. However, these findings 
      need to be verified in the Middle Eastern context, where patients may exhibit a 
      different response due to different environmental and racial factors. OBJECTIVES: 
      The goal of this study was to evaluate the efficacy of submaximal 
      sacubitril/valsartan doses in terms of improving the disease symptoms, as 
      measured by the New York Heart Association (NYHA) classification and left 
      ventricular ejection fraction (LVEF) percentage, as well as establish long-term 
      morbidity and mortality associated with HFrEF among Palestinian patients 
      administered target doses of an angiotensin-converting enzyme inhibitors (ACEI) 
      or angiotensin II receptor blockers (ARBs). Material and Methods. This study 
      involved a retrospective review of charts related to patients with HFrEF 
      maintained on sacubitril/valsartan and was conducted in a referral cardiology 
      clinic in Palestine. The inclusion criteria were age 18+, HFrEF diagnosis, 
      sacubitril/valsartan usage for at least six months during the period between 
      January 1, 2016, and June 30, 2019, and LVEF < 40%. The exclusion criteria 
      included LVEF >/= 40% and drug administration duration < 6 months. The collected 
      data included NYHA class, as well as LVEF, serum sodium (Na), potassium (K), 
      serum creatinine (Cr), and blood urea nitrogen (BUN) levels and the mortality 
      rate before and after the minimum treatment duration. IBM SPSS STATISTICS for 
      Windows, version 20.0, Armonk, NY: IBM Corp. IBM Corp., released 2012, was used 
      for data analysis, whereby T score was calculated for comparisons between 
      numerical groups, and p < 0.05 was considered statistically significant. RESULTS: 
      The initial study sample comprised of 205 consecutive patients with HFrEF 
      maintained on sacubitril/valsartan for at least six months from January 1, 2016, 
      to June 30, 2019. Three patients were excluded due to attrition, along with 
      further 12 patients with LVEF >/= 40% (based on the PARADIGM-HF trial criteria). 
      Throughout the treatment period, most patients showed escalating improvement in 
      terms of the LVEF and NYHA classification, as LVEF = 29.8% and NYHA = 3 were 
      obtained on average before initiating sacubitril/valsartan, compared to 41% and 
      1.7, respectively, after 6-month treatment (p = 0.0003 and 0.046, respectively). 
      These improvements in LVEF and NYHA class were noted across all 
      sacubitril/valsartan doses (50-400 mg). However, 23 patients (12%) died while 
      undergoing sacubitril/valsartan treatment. CONCLUSION: A significant long-term 
      reduction in the mortality and morbidity rates was observed in Palestinian 
      patients with HFrEF maintained on submaximal doses of sacubitril/valsartan.
CI  - Copyright (c) 2021 Raed Aqel et al.
FAU - Aqel, Raed
AU  - Aqel R
AUID- ORCID: 0000-0003-3166-8305
AD  - National Center for Diabetes, Endocrinology and Genetics, Jordan.
FAU - Alzughayyar, Tareq Z
AU  - Alzughayyar TZ
AUID- ORCID: 0000-0002-7419-0228
AD  - College of Medicine and Health Sciences, Palestine Polytechnic University, 
      Hebron, State of Palestine.
FAU - Abukhalaf, Sadi A
AU  - Abukhalaf SA
AUID- ORCID: 0000-0002-7433-3698
AD  - Al-Quds University, Faculty of Medicine, Jerusalem, State of Palestine.
FAU - Misk, Rami A
AU  - Misk RA
AUID- ORCID: 0000-0002-6376-8805
AD  - College of Medicine and Health Sciences, Palestine Polytechnic University, 
      Hebron, State of Palestine.
FAU - Zalloum, Jihad Samer
AU  - Zalloum JS
AUID- ORCID: 0000-0002-1309-0880
AD  - Al-Quds University, Faculty of Medicine, Jerusalem, State of Palestine.
LA  - eng
PT  - Journal Article
DEP - 20211228
PL  - England
TA  - J Renin Angiotensin Aldosterone Syst
JT  - Journal of the renin-angiotensin-aldosterone system : JRAAS
JID - 100971636
RN  - 0 (Aminobutyrates)
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Biphenyl Compounds)
RN  - 0 (Drug Combinations)
RN  - 0 (Tetrazoles)
RN  - 17ERJ0MKGI (sacubitril)
RN  - 80M03YXJ7I (Valsartan)
SB  - IM
MH  - Aminobutyrates
MH  - Angiotensin Receptor Antagonists/therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors
MH  - Arabs
MH  - Biphenyl Compounds
MH  - Drug Combinations
MH  - *Heart Failure/drug therapy
MH  - Humans
MH  - Infant
MH  - Morbidity
MH  - Pilot Projects
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Tetrazoles/therapeutic use
MH  - Treatment Outcome
MH  - Valsartan
MH  - Ventricular Function, Left
PMC - PMC8727118
COIS- There are no conflicts of interest to declare.
EDAT- 2022/01/15 06:00
MHDA- 2022/01/18 06:00
PMCR- 2021/12/28
CRDT- 2022/01/14 06:01
PHST- 2021/06/22 00:00 [received]
PHST- 2021/09/09 00:00 [revised]
PHST- 2021/11/30 00:00 [accepted]
PHST- 2022/01/14 06:01 [entrez]
PHST- 2022/01/15 06:00 [pubmed]
PHST- 2022/01/18 06:00 [medline]
PHST- 2021/12/28 00:00 [pmc-release]
AID - 10.1155/2021/1829873 [doi]
PST - epublish
SO  - J Renin Angiotensin Aldosterone Syst. 2021 Dec 28;2021:1829873. doi: 
      10.1155/2021/1829873. eCollection 2021.