Effects of Sacubitril/Valsartan on Glycemic Control in Japanese Patients With Heart Failure and/or Hypertension
Kahomi Sazawa1,2, Kohei Ohno1, Tomohisa Yamashita2
1Department of Cardiology and Diabetes, Oji General Hospital Tomakomai Japan.
Insights
Sacubitril/valsartan (S/V) improved glycemic control, particularly in patients with diabetes, and reduced blood pressure and NT-proBNP levels in heart failure patients. This suggests S/V is beneficial for diabetic individuals with cardiovascular conditions.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Sacubitril/valsartan (S/V) demonstrated efficacy in heart failure (HF) trials.
- Previous analyses suggested S/V may improve glycemic control in patients with HF and diabetes.
Purpose of the Study:
- To retrospectively analyze the effect of S/V on glycemic control in patients with HF and/or hypertension.
- To identify factors influencing glycemic changes with S/V treatment.
Main Methods:
- Retrospective analysis of 150 patients treated with S/V for HF and/or hypertension.
- Assessment of changes in HbA1c, renal function, systolic blood pressure, and NT-proBNP.
- Multiple regression analysis to identify independent predictors of HbA1c reduction.
Main Results:
- Mean HbA1c significantly decreased from 6.56% to 6.49% after 13 weeks, primarily in diabetic patients.
- Systolic blood pressure and NT-proBNP levels significantly decreased.
- Diabetes status, not HF, was an independent predictor of HbA1c reduction.
Conclusions:
- Sacubitril/valsartan treatment improves glycemic control in patients with HF and/or hypertension, especially those with diabetes.
- The favorable effect on glucose metabolism may be linked to neprilysin inhibition.
- S/V offers a desirable therapeutic option for diabetic patients with HF and hypertension.
Abstract:
Post hoc analysis of the PARADIGM-HF trial showed that sacubitril/valsartan (S/V) was more effective than enalapril in lowering HbA1c in patients with heart failure and diabetes. In the present study, the effect of S/V on glycemic control was retrospectively analyzed in 150 patients (median age 74 years) who were prescribed S/V for the treatment of heart failure and/or hypertension. After a median period of 13 weeks treatment, mean (±SD) HbA1c levels decreased significantly from 6.56±0.68% to 6.49±0.63%. The decrease in HbA1c was evident in patients with (n=111), but not in those without, diabetes. There were no significant changes in renal function after S/V treatment, but systolic blood pressure was significantly reduced from 141±21 to 134±19 mmHg. Ninety patients had N-terminal pro B-type natriuretic peptide (NT-proBNP) tested, and S/V significantly decreased median NT-proBNP concentrations from 1,026 to 618 pg/mL; however, there was no correlation between the degree of decrease in HbA1c and that in NT-proBNP. Multiple regression analysis revealed that being diabetic, rather than having heart failure, was a significant independent variable for a reduction in HbA1c. Treatment with S/V improved glycemic control in patients with heart failure and/or hypertension, especially in those with concomitant diabetes. This favorable effect on glucose metabolism may be mediated by neprilysin inhibition and is desirable in the treatment of heart failure and hypertension in diabetic patients.
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