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Evaluating Sacubitril/Valsartan Dose Dependence on Clinical Outcomes in Patients With Heart Failure With Reduced

Kazuhiko Kido1, Christopher Bianco2, Marco Caccamo2

  • 1West Virginia University School of Pharmacy, Morgantown, WV, USA.

The Annals of Pharmacotherapy
|January 1, 2021
PubMed

Insights

Higher doses of sacubitril/valsartan (97/103 mg or 49/51 mg) significantly reduced heart failure (HF) hospitalization and all-cause mortality compared to the lowest dose (24/26 mg) in patients with HF with reduced ejection fraction (HFrEF).

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Research

Background:

  • Limited evidence exists for low (24/26 mg) and moderate (49/51 mg) doses of sacubitril/valsartan.
  • Understanding dose-response relationships is crucial for optimizing heart failure treatment.

Purpose of the Study:

  • To evaluate the impact of different sacubitril/valsartan dosages on heart failure (HF) hospitalization and mortality.
  • To compare the efficacy of 24/26 mg, 49/51 mg, and 97/103 mg doses in patients with HF with reduced ejection fraction (HFrEF).

Main Methods:

  • Retrospective multicenter cohort study involving patients with HFrEF.
  • Compared three doses of sacubitril/valsartan: 24/26 mg, 49/51 mg, and 97/103 mg.
  • Utilized propensity matching analysis to control for confounding factors; coprimary outcomes were all-cause mortality and HF rehospitalization.

Main Results:

  • Higher doses of sacubitril/valsartan were associated with reduced HF hospitalization rates.
  • The 97/103-mg group showed the lowest hospitalization rate (16.10%), followed by the 49/51-mg group (19.51%), compared to the 24/26-mg group (29.14%).
  • All-cause mortality was significantly lower in the 49/51-mg (17.58%) and 97/103-mg (9.27%) groups compared to the 24/26-mg group (29.63%).

Conclusions:

  • Sacubitril/valsartan at 97/103 mg or 49/51 mg is associated with significantly lower rates of HF hospitalization and all-cause mortality.
  • The findings support the use of higher doses of sacubitril/valsartan for improved outcomes in HFrEF patients.
  • Optimizing sacubitril/valsartan dosage is essential for managing heart failure effectively.
Abstract

Keywords:
dose dependenceheart failureneprilysin inhibitorsacubitrilvalsartan

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