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ARNI in HFrEF-One-Centre Experience in the Era before the 2021 ESC HF Recommendations.
- Source :
-
International journal of environmental research and public health [Int J Environ Res Public Health] 2022 Feb 13; Vol. 19 (4). Date of Electronic Publication: 2022 Feb 13. - Publication Year :
- 2022
-
Abstract
- Background: Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), has demonstrated a survival benefit and reduces heart failure hospitalization in patients with heart failure with reduced left ventricular ejection fraction (HFrEF); however, our experience in this field is limited. This study aimed to summarize a real clinical practice of the use of ARNI in HFrEF patients hospitalized due to HFrEF in the era before the 2021 ESC HF recommendations, as well as assess their clinical outcome with regard to ARNI administration.<br />Methods and Materials: Overall, 613 patients with HFrEF hospitalized in 2018-2020 were enrolled into a retrospective one-centre cross-sectional analysis. The study population was categorized into patients receiving (82/13.4%) and not-receiving (531/82.6%) ARNI. Clinical outcomes defined as rehospitalization, number of rehospitalizations, time to the first rehospitalization and death from any cause were analysed in the 1-2 year follow-up in the ARNI and non-ARNI groups, matched as to age and LVEF.<br />Results: Clinical characteristics revealed the following differences between ARNI and non-ARNI groups: A higher percentage of cardiovascular implantable electronic devices (CIED) ( p = 0.014) and defibrillators with cardiac resynchronization therapy (CRT-D) ( p = 0.038), higher frequency of atrial fibrillation ( p = 0.002) and history of stroke ( p = 0.024) were in the ARNI group. The percentage of patients with HFrEF NYHA III/IV presented an increasing trend to be higher in the ARNI (64.1%) as compared to the non-ARNI group (51.5%, p = 0.154). Incidence of rehospitalization, number of rehospitalizations and time to the first rehospitalization were comparable between the groups. There were no differences between the numbers of deaths of any cause in the ARNI (28%) and non-ARNI (28%) groups. The independent negative predictor of death in the whole population of ARNI and non-ARNI groups was the coexistence of coronary artery disease (CAD) (beta= -0.924, HR 0.806, p = 0.011).<br />Conclusions: Our current positive experience in ARNI therapy is limited to extremely severe patients with HFrEF. Regardless of the more advanced HF and HF comorbidities, the patients treated with ARNI presented similar mortality and rehospitalizations as the patients treated by standard therapy.
- Subjects :
- Cross-Sectional Studies
Drug Combinations
Humans
Retrospective Studies
Stroke Volume
Treatment Outcome
Ventricular Function, Left
Aminobutyrates therapeutic use
Angiotensin Receptor Antagonists therapeutic use
Biphenyl Compounds therapeutic use
Heart Failure drug therapy
Heart Failure epidemiology
Valsartan therapeutic use
Ventricular Dysfunction, Left drug therapy
Ventricular Dysfunction, Left epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1660-4601
- Volume :
- 19
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- International journal of environmental research and public health
- Publication Type :
- Academic Journal
- Accession number :
- 35206278
- Full Text :
- https://doi.org/10.3390/ijerph19042089