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Our Experience With Sacubitril/Valsartan in Chronic Heart Failure Management - HFrEF in the Ambulatory Setting

Nabil Naser1,2, Mehmed Kulić3, Zaim Jatić2,4

  • 1Polyclinic "Dr. Nabil", Sarajevo, Bosnia and Herzegovina.

Medical Archives (Sarajevo, Bosnia and Herzegovina)
|July 1, 2022
PubMed

Insights

Sacubitril/valsartan significantly improved heart function and reduced mortality in patients with heart failure with reduced ejection fraction (HFrEF). This therapy demonstrated "hemodynamic recovery" and better outcomes compared to standard optimal medical therapy.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Chronic heart failure (CHF) affects 1-2% of adults in developed countries, increasing to over 10% after age 70.
  • Heart failure with reduced ejection fraction (HFrEF) is a major cause of morbidity and mortality.

Purpose of the Study:

  • To evaluate the clinical efficacy of sacubitril/valsartan in ambulatory HFrEF patients.
  • To assess sacubitril/valsartan's effects on hemodynamic, metabolic, renal, and cardiac remodeling parameters.

Main Methods:

  • 106 ambulatory HFrEF patients were prospectively enrolled from January 2018 to May 2021.
  • Patients receiving sacubitril/valsartan (ARNI) were compared to a control group of 53 patients on optimal medical therapy (OMT).
  • Follow-up duration was 12 months, assessing various clinical and echocardiographic parameters.

Main Results:

  • Sacubitril/valsartan significantly increased left ventricular ejection fraction (LVEF) (42.1% vs. 30.1%) and improved estimated glomerular filtration rate (eGFR) (70.1 vs. 64.9 mL/min/1.73 m2).
  • Left ventricular mass index (LVMI) decreased, and NT-pro-BNP levels were significantly reduced in the ARNI group.
  • The ARNI group showed lower mortality (20.3% vs. 32.4%) and re-hospitalization rates (25.3% vs. 46.6%) due to HF.

Conclusions:

  • Sacubitril/valsartan represents a significant advancement in HFrEF treatment, inducing
Abstract

Keywords:
Ambulatory settingsChronic heart failure managmentHeart failure with reduced ejection fraction (HFrEF)Sacubitril/Valsartan

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