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Sacubitril/valsartan can improve the cardiac function in heart failure patients with a history of cancer: An
Zhulu Chen1, Chuan Zhang1, Yuxi Zhu2
1Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Insights
Sacubitril/Valsartan improved cardiac function in elderly cancer patients with heart failure (HF). This combination therapy showed benefits across all HF types, including reduced cardiac remodeling and improved ejection fraction.
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- Sacubitril/Valsartan is recommended for heart failure with reduced ejection fraction (HFrEF).
- Limited evidence exists on Sacubitril/Valsartan's efficacy in elderly cancer patients with different types of heart failure (HFmrEF and HFpEF).
Purpose of the Study:
- To investigate the effects of Sacubitril/Valsartan on cardiac function in elderly cancer patients with various forms of heart failure.
- To compare Sacubitril/Valsartan treatment against conventional therapy in this specific patient population.
Main Methods:
- Retrospective study of cancer patients over 65 with heart failure.
- Patients were divided into Sacubitril/Valsartan group and a control group receiving conventional HF therapy.
- Data collected for up to 9 months, analyzing cardiac parameters and clinical outcomes.
Main Results:
- The Sacubitril/Valsartan group showed significant improvements in left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), and NT-proBNP levels at 3, 6, and 9 months.
- Better New York Heart Association (NYHA) functional classification was observed post-treatment in the Sacubitril/Valsartan group.
- Fewer cases of deterioration in left atrial diameter (LAD) and left ventricular end-diastolic diameter (LVEDD) were noted in the Sacubitril/Valsartan group.
Conclusions:
- Sacubitril/Valsartan improves cardiac function and benefits cardiac remodeling in elderly cancer patients across all three types of heart failure.
- This study provides novel evidence supporting the use of Sacubitril/Valsartan in this vulnerable patient group.
Abstract:
Sacubitril/Valsartan, the combination of angiotensin receptor inhibitor and neprilysin inhibitor, is now becoming the class 1 recommendation for HFrEF. Some studies have shown the positive effect of Sacubitril/Valsartan on HFrEF cancer patients, while there is devoid of evidence about the effect of this drug in aged cancer patients with HFmrEF and HFpEF. By searching the patients with a diagnosis of both cancer and Heart failure (HF) over 65, the patients who had received treatment with Sacubitril/Valsartan were selected as the candidates for Sacubitril/Valsartan group, and the patients who had received conventional HF therapy without Sacubitril/Valsartan were chosen as the control group. Data were collected for up to 9 months. We filtered 38 patients and 50 patients valid for Sacubitril/Valsartan group and control group, respectively. After initiation of heart failure management, our study found a better cardiac condition in Sacubitril/Valsartan group, having better LVEF, LVFS, NT-proBNP in 3rd, 6th, 9th month (P < .05) and better NYHA function classification after the treatment. We also observed fewer cases of deterioration on LAD (P = .029) and LVEDD (P = .023) in Sacubitril/Valsartan group. In subgroup analysis, our study showed that all 3 kinds of HF patients had better LVEF, LVFS, and NT-proBNP in Sacubitril/Valsartan group (P < .05). Our study further indicated that Sacubitril/Valsartan can improve cardiac function and benefit cardiac remolding in aged cancer patients of all 3 kinds of HF. This is the first study to provide new evidence for the use of Sacubitril/Valsartan in aged cancer patients of 3 kinds of HF.
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