PMID- 36216094 OWN - NLM STAT- MEDLINE DCOM- 20221216 LR - 20221221 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 370 DP - 2023 Jan 1 TI - Association between sacubitril/valsartan initiation and changes in left ventricular ejection fraction: Insights from ARIADNE registry. PG - 279-286 LID - S0167-5273(22)01480-2 [pii] LID - 10.1016/j.ijcard.2022.10.012 [doi] AB - AIMS: We tested the hypothesis that initiation versus non-initiation of sacubitril/valsartan is associated with a more favorable subsequent change in left ventricular ejection fraction (LVEF) in a real-world setting. METHODS: A prospective, non-randomized, double-arm, open-label, cohort study had been conducted across 687 centers in 17 European countries enrolling HFrEF patients aged >/=18 years with symptoms of HF (New York Heart Association [NYHA] II-IV) and "reduced LVEF". For the current analysis, 2602 patients with LVEF measured at baseline and follow-up were chosen, of which 860 (33%, mean age 67 years, 26% women) were started on sacubitril/valsartan at baseline and 1742 (67%, 68 years, 23% women) were not. Patients started on sacubitril/valsartan had higher NYHA class and lower LVEF. RESULTS: LVEF increased from mean 32.7% to 38.1% in the sacubitril/valsartan group versus from 35.9% to 38.7% in the non-sacubitril/valsartan group (mean difference in increase 2.6%, p < 0.001). LVEF increased from baseline in 64% versus 53% of patients and increased by >/=5% (absolute %) in 50% versus 35% of patients in the sacubitril/valsartan versus non-sacubitril/valsartan groups, respectively. In the overall cohort, initiation of sacubitril/valsartan was independently associated with any increase in LVEF (adjusted odds ratio [OR] 1.49 [1.26-1.75]) and with increase by >/=5% (OR 1.65 [1.39-1.95]). CONCLUSION: Initiating versus not initiating sacubitril/valsartan was independently associated with a greater subsequent increase in LVEF in this real-world setting. Reverse cardiac remodeling may be one mechanism of benefit of sacubitril/valsartan. CI - Copyright (c) 2022 Elsevier B.V. All rights reserved. FAU - Lund, Lars H AU - Lund LH AD - Department of Medicine, Karolinska Institutet, And Heart Vascular and Neuro Theme Karolinska University Hospital, Stockholm, Sweden. Electronic address: lars.lund@alumni.duke.edu. FAU - Zeymer, Uwe AU - Zeymer U AD - Klinikum Ludwigshafen and Institut fur Herzinfarktforschung, Ludwigshafen-am-Rhein, Germany. FAU - Clark, Andrew L AU - Clark AL AD - Castle Hill Hospital, Kingston Upon Hull, United Kingdom. FAU - Barrios, Vivencio AU - Barrios V AD - University Hospital Ramon y Cajal de Madrid, Madrid, Spain. FAU - Damy, Thibaud AU - Damy T AD - University Hospital Henri Mondor, Creteil, France. FAU - Drozdz, Jaroslaw AU - Drozdz J AD - Medical University of Lodz, Lodz, Poland. FAU - Fonseca, Candida AU - Fonseca C AD - Hospital de Sao Francisco Xavier, CHLO, NOVA Medical School, Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisbon, Portugal. FAU - Kalus, Stefanie AU - Kalus S AD - GKM Gesellschaft fur Therapieforschung mbH, Munich, Germany. FAU - Ferber, Philippe C AU - Ferber PC AD - Novartis Pharma AG, Basel, Switzerland. FAU - Koch, Cornelia AU - Koch C AD - Novartis Pharma AG, Basel, Switzerland. FAU - Maggioni, Aldo P AU - Maggioni AP AD - Associazione Nazionale Medici Cardiologi Ospedalieri Research Center, Florence, Italy; Maria Cecilia Hospital, GVM Care & Research, Italy. CN - ARIADNE investigators LA - eng PT - Journal Article DEP - 20221007 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Tetrazoles) RN - 0 (Angiotensin Receptor Antagonists) RN - 0 (Aminobutyrates) RN - 80M03YXJ7I (Valsartan) RN - 0 (Biphenyl Compounds) RN - 0 (Drug Combinations) SB - IM MH - Humans MH - Female MH - Adolescent MH - Adult MH - Aged MH - Male MH - Stroke Volume MH - *Heart Failure/diagnosis/drug therapy MH - Prospective Studies MH - Cohort Studies MH - Ventricular Function, Left MH - Tetrazoles/therapeutic use MH - Angiotensin Receptor Antagonists/therapeutic use MH - Treatment Outcome MH - Aminobutyrates/therapeutic use MH - Valsartan MH - Biphenyl Compounds MH - Drug Combinations OTO - NOTNLM OT - Heart failure OT - Left ventricular ejection fraction OT - Real-world OT - Reverse cardiac remodeling OT - Sacubitril/valsartan OT - Trial registration: EUPAS 13835. COIS- Declaration of Competing Interest LHL reports research grants from AstraZeneca, Novartis, Boehringer Ingelheim, Vifor-Fresenius, and Boston Scientific; consulting or speaker's honoraria from AstraZeneca, Novartis, Boehringer Ingelheim, Vifor-Fresenius, Bayer, Pharmacosmos, Abbott, Sanofi, Merck, Myokardia, Orion Pharma, MedScape, Radcliffe Cardiology, Lexicon, and Respicardia; and stock ownership in AnaCardio; outside the submitted work. UZ has received research funding as well as speaker and consulting honoraria from Novartis. ALC has received funding for travel to meetings from Novartis as well as unrestricted grants for the support of his department. VB has received funding for travel to meetings from Novartis as well as fees for lectures and unrestricted grants for clinical research. JD has received honoraria for participation in committees of studies sponsored by Novartis. CF has received speaker fees and honoraria for consulting from Novartis, Servier, Bayer, OMPharma, and Daiichi Sankyo. SK is an employee of GKM (clinical research organization) contracted for data analysis by Novartis. PCF and CK are employees of Novartis. APM has received personal fees for participation in study committees of trials funded by Novartis, Bayer, Cardiorentis, and Fresenius. EDAT- 2022/10/11 06:00 MHDA- 2022/12/15 06:00 CRDT- 2022/10/10 19:23 PHST- 2022/08/08 00:00 [received] PHST- 2022/09/29 00:00 [revised] PHST- 2022/10/05 00:00 [accepted] PHST- 2022/10/11 06:00 [pubmed] PHST- 2022/12/15 06:00 [medline] PHST- 2022/10/10 19:23 [entrez] AID - S0167-5273(22)01480-2 [pii] AID - 10.1016/j.ijcard.2022.10.012 [doi] PST - ppublish SO - Int J Cardiol. 2023 Jan 1;370:279-286. doi: 10.1016/j.ijcard.2022.10.012. Epub 2022 Oct 7.