1. Association Between Sacubitril/Valsartan Initiation and Health Status Outcomes in Heart Failure With Reduced Ejection Fraction
- Author
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Khariton, Yevgeniy, Fonarow, Gregg C, Arnold, Suzanne V, Hellkamp, Ann, Nassif, Michael E, Sharma, Puza P, Butler, Javed, Thomas, Laine, Duffy, Carol I, DeVore, Adam D, Albert, Nancy M, Patterson, J Herbert, Williams, Fredonia B, McCague, Kevin, and Spertus, John A
- Subjects
Cardiovascular ,Clinical Research ,Heart Disease ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Good Health and Well Being ,Aged ,Aminobutyrates ,Angiotensin Receptor Antagonists ,Biphenyl Compounds ,Cohort Studies ,Drug Combinations ,Female ,Health Status ,Heart Failure ,Humans ,Male ,Middle Aged ,Neprilysin ,Stroke Volume ,Tetrazoles ,Treatment Outcome ,Valsartan ,health status ,heart failure ,sacubitril/valsartan ,Cardiorespiratory Medicine and Haematology - Abstract
ObjectivesThis study sought to describe the short-term health status benefits of angiotensin-neprilysin inhibitor (ARNI) therapy in patients with heart failure and reduced ejection fraction (HFrEF).BackgroundAlthough therapy with sacubitril/valsartan, a neprilysin inhibitor, improved patients' health status (compared with enalapril) at 8 months in the PARADIGM-HF (Prospective Comparison of ARNI with ACE inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) study, the early impact of ARNI on patients' symptoms, functions, and quality of life is unknown.MethodsHealth status was assessed by using the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ) in 3,918 outpatients with HFrEF and left ventricular ejection fraction ≤40% across 140 U.S. centers in the CHAMP-HF (Change the Management of Patients with Heart Failure) registry. ARNI therapy was initiated in 508 patients who were matched 1:2 to 1,016 patients who were not initiated on ARNI (no-ARNI), using a nonparsimonious time-dependent propensity score (6 sociodemographic factors, 23 clinical characteristics), prior KCCQ overall summary (KCCQ-OS) score, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker status.ResultsMultivariate linear regression demonstrated a greater mean improvement in KCCQ-OS in patients initiated on ARNI therapy (5.3 ± 19 vs. 2.5 ± 17.4, respectively; p
- Published
- 2019