PMID- 35919657 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230918 IS - 2752-4191 (Electronic) IS - 2752-4191 (Linking) VI - 2 IP - 1 DP - 2022 Jan TI - Sacubitril/valsartan reduces indications for arrhythmic primary prevention in heart failure with reduced ejection fraction: insights from DISCOVER-ARNI, a multicenter Italian register. PG - oeab046 LID - 10.1093/ehjopen/oeab046 [doi] LID - oeab046 AB - AIMS: This sub-study deriving from a multicentre Italian register [Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril-Valsartan: A Multicenter Echocardiographic Registry (DISCOVER)-ARNI] investigated whether sacubitril/valsartan in addition to optimal medical therapy (OMT) could reduce the rate of implantable cardioverter-defibrillator (ICD) indications for primary prevention in heart failure with reduced ejection fraction (HFrEF) according to European guidelines indications, and its potential predictors. METHODS AND RESULTS: In this observational study, consecutive patients with HFrEF eligible for sacubitril/valsartan from 13 Italian centres were included. Lack of follow-up or speckle tracking data represented exclusion criteria. Demographic, clinical, biochemical, and echocardiographic data were collected at baseline and after 6 months from sacubitril/valsartan initiation. Of 351 patients, 225 (64%) were ICD carriers and 126 (36%) were not ICD carriers (of whom 13 had no indication) at baseline. After 6 months of sacubitril/valsartan, among 113 non-ICD carriers despite having baseline left ventricular (LV) ejection fraction (EF) moderate, left atrial volume index (LAVi), and LV global longitudinal strain (GLS) significantly varied between the groups. With receiver operating characteristic curves, age >/= 75 years, LAVi >/= 42 mL/m(2) and LV GLS >/=-8.3% were associated with ICD indications persistence (area under the curve = 0.65, 0.68, 0.68, respectively). With univariate and multivariate analysis, only LV GLS emerged as significant predictor of ICD indications at follow-up in different predictive models. CONCLUSIONS: Sacubitril/valsartan may provide early improvement of NYHA class and LVEF, reducing the possible number of implanted ICD for primary prevention in HFrEF. Baseline reduced LV GLS was a strong marker of ICD indication despite OMT. Early therapy with sacubitril/valsartan may save infective/haemorrhagic risks and unnecessary costs deriving from ICDs. CI - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. FAU - Pastore, Maria Concetta AU - Pastore MC AUID- ORCID: 0000-0002-7223-141X AD - Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100, Siena, Italy. FAU - Mandoli, Giulia Elena AU - Mandoli GE AD - Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100, Siena, Italy. FAU - Giannoni, Alberto AU - Giannoni A AD - Cardiology and Cardiovascular Medicine Department, Fondazione Toscana G. Monasterio, Via Giuseppe Moruzzi, 1, 56124 Pisa, Italy. AD - Institute of Life Sciences, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta, 33, 56127 Pisa, Italy. FAU - Benfari, Giovanni AU - Benfari G AD - Section of Cardiology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy. FAU - Dini, Frank Lloyd AU - Dini FL AD - Centro Medico Sant'Agostino, via Temperanza 6, 20127 Milano, Italy. FAU - Pugliese, Nicola Riccardo AU - Pugliese NR AD - Department of Clinical and Experimental Medicine, University of Pisa, Lungarno Antonio Pacinotti, 43, 56126 Pisa, Italy. FAU - Taddei, Claudia AU - Taddei C AD - Cardiology and Cardiovascular Medicine Department, Fondazione Toscana G. Monasterio, Via Giuseppe Moruzzi, 1, 56124 Pisa, Italy. FAU - Correale, Michele AU - Correale M AD - Cardiology Department, Policlinico Riuniti University Hospital Foggia, Viale Pinto, 1 71100 Foggia, Italy. FAU - Brunetti, Natale Daniele AU - Brunetti ND AD - Department of Medical and Surgical Sciences, University of Foggia, Via Antonio Gramsci, 89, 71122 Foggia, Italy. FAU - Carluccio, Erberto AU - Carluccio E AD - Cardiology and Cardiovascular Pathophysiology-Heart Failure Unit, 'Santa Maria della Misericordia' Hospital, University of Perugia, Piazzale Giorgio Menghini, 1, 06129 Perugia, Italy. FAU - Mengoni, Anna AU - Mengoni A AD - Cardiology and Cardiovascular Pathophysiology-Heart Failure Unit, 'Santa Maria della Misericordia' Hospital, University of Perugia, Piazzale Giorgio Menghini, 1, 06129 Perugia, Italy. FAU - Guaricci, Andrea Igoren AU - Guaricci AI AD - University Cardiology Unit, Cardiothoracic Department, Polyclinic University Hospital, Policlinico Bari, piazza Giulio Cesare n.11, 70120 Bari, Italy. FAU - Piscitelli, Laura AU - Piscitelli L AD - University Cardiology Unit, Cardiothoracic Department, Polyclinic University Hospital, Policlinico Bari, piazza Giulio Cesare n.11, 70120 Bari, Italy. FAU - Citro, Rodolfo AU - Citro R AD - Cardio-Thoracic-Vascular Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Via San Leonardo, 84125 Salerno, Italy. FAU - Ciccarelli, Michele AU - Ciccarelli M AD - Department of Medicine, Surgery and Dentistry, University of Salerno, Via Giovanni Paolo II, 132, 84084 Fisciano, Salerno, Italy. FAU - Novo, Giuseppina AU - Novo G AD - Division of Cardiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University Hospital Paolo Giaccone, University of Palermo, Via del Vespro, 129 , 90127 Palermo, Italy. FAU - Corrado, Egle AU - Corrado E AD - Division of Cardiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University Hospital Paolo Giaccone, University of Palermo, Via del Vespro, 129 , 90127 Palermo, Italy. FAU - Pasquini, Annalisa AU - Pasquini A AD - Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Universita Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168 Roma, Italy. FAU - Loria, Valentina AU - Loria V AD - Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Universita Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168 Roma, Italy. FAU - Degiovanni, Anna AU - Degiovanni A AD - Department of Thoracic, Heart and Vascular Diseases, Maggiore Della Carita Hospital, Corso Mazzini 18, 28100 Novara, Italy. FAU - Patti, Giuseppe AU - Patti G AD - Department of Thoracic, Heart and Vascular Diseases, Maggiore Della Carita Hospital, Corso Mazzini 18, 28100 Novara, Italy. AD - Department of Translational Medicine, University of Piemonte Orientale, Via Paolo Solaroli, 17, 28100 Novara, Italy. FAU - Santoro, Ciro AU - Santoro C AD - Department of Advanced Biomedical Science, Federico II University Hospital, Via Sergio Pansini, 5, 80131 Napoli, Italy. FAU - Moderato, Luca AU - Moderato L AD - Cardiology Department, Ospedale Guglielmo da Saliceto-Piacenza, Via Taverna Giuseppe, 49, 29121 Piacenza, Italy. FAU - Malagoli, Alessandro AU - Malagoli A AD - Division of Cardiology, Nephro-Cardiovascular Department, Baggiovara Hospital, University of Modena and Reggio-Emilia, Via Pietro Giardini, 1355, 41126, Baggiovara, Modena, Italy. FAU - Emdin, Michele AU - Emdin M AD - Cardiology and Cardiovascular Medicine Department, Fondazione Toscana G. Monasterio, Via Giuseppe Moruzzi, 1, 56124 Pisa, Italy. AD - Institute of Life Sciences, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta, 33, 56127 Pisa, Italy. FAU - Cameli, Matteo AU - Cameli M AD - Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100, Siena, Italy. CN - Collaborators: DISCOVER-ARNI Collaborators FAU - Rosa, Gianmarco AU - Rosa G AD - Department of Internal Medicine and Medical Specialities, University of Genoa, Via Balbi 5, 16126 Genova, Italy. FAU - Magnesa, Michele AU - Magnesa M AD - Cardiology Department, Policlinico Riuniti University Hospital Foggia, Viale Pinto, 1 71100 Foggia, Italy. FAU - Mazzeo, Pietro AU - Mazzeo P AD - Department of Medical and Surgical Sciences, University of Foggia, Via Antonio Gramsci, 89, 71122 Foggia, Italy. FAU - De Carli, Giuseppe AU - De Carli G AD - Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100, Siena, Italy. FAU - Bellino, Michele AU - Bellino M AD - Cardio-Thoracic-Vascular Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Via San Leonardo, 84125 Salerno, Italy. FAU - Iuliano, Giuseppe AU - Iuliano G AD - Cardio-Thoracic-Vascular Department, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Via San Leonardo, 84125 Salerno, Italy. FAU - Casciano, Ofelia AU - Casciano O AD - Department of Advanced Biomedical Science, Federico II University Hospital, Via Sergio Pansini, 5, 80131 Napoli, Italy. FAU - Binno, Simone AU - Binno S AD - Cardiology Department, Ospedale Guglielmo da Saliceto-Piacenza, Via Taverna Giuseppe, 49, 29121 Piacenza, Italy. FAU - Canepa, Marco AU - Canepa M AD - Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, IRCCS Italian Cardiovascular Network, Largo Rosanna Benzi, 10, 16132 Genova, Italy. AD - Department of Internal Medicine, University of Genova, Via Balbi 5, 16126 Genova, Italy. FAU - Tondi, Stefano AU - Tondi S AD - Division of Cardiology, Nephro-Cardiovascular Department, Baggiovara Hospital, University of Modena and Reggio-Emilia, Via Pietro Giardini, 1355, 41126, Baggiovara, Modena, Italy. FAU - Cicoira, Mariantonietta AU - Cicoira M AD - Institute of Life Sciences, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta, 33, 56127 Pisa, Italy. FAU - Mega, Simona AU - Mega S AD - Cardiocenter and Unit of Cardiology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 21, 00128 Roma, Italy. LA - eng PT - Journal Article DEP - 20211221 PL - England TA - Eur Heart J Open JT - European heart journal open JID - 9918282081406676 PMC - PMC9242049 OTO - NOTNLM OT - Heart failure OT - Implantable cardioverter-defibrillator OT - Left ventricular strain OT - Remodelling OT - Sacubitril/valsartan EDAT- 2022/08/04 06:00 MHDA- 2022/08/04 06:01 PMCR- 2021/12/21 CRDT- 2022/08/03 02:11 PHST- 2021/06/29 00:00 [received] PHST- 2021/10/03 00:00 [revised] PHST- 2021/12/17 00:00 [accepted] PHST- 2022/08/03 02:11 [entrez] PHST- 2022/08/04 06:00 [pubmed] PHST- 2022/08/04 06:01 [medline] PHST- 2021/12/21 00:00 [pmc-release] AID - oeab046 [pii] AID - 10.1093/ehjopen/oeab046 [doi] PST - epublish SO - Eur Heart J Open. 2021 Dec 21;2(1):oeab046. doi: 10.1093/ehjopen/oeab046. eCollection 2022 Jan.