Efficacy and safety of sacubitril/valsartan after six months in patients with heart failure with reduced ejection fraction and asymptomatic hypotension.
| Autor: | An-Hu WU, Zong-Wei LIN, Zhuo-Hao YANG, Hui ZHANG, Jia-Yi HU, Yi WANG, Rui TANG, Xin-Yu ZHANG, Xiao-Ping JI, Hui-Xia LU |
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| Předmět: |
ANTIHYPERTENSIVE agents
DRUG efficacy STATISTICS VENTRICULAR ejection fraction DRUG tolerance SCIENTIFIC observation TIME SYSTOLIC blood pressure RETROSPECTIVE studies PAIRED comparisons (Mathematics) FISHER exact test TREATMENT effectiveness T-test (Statistics) PEARSON correlation (Statistics) VALSARTAN CHI-squared test DESCRIPTIVE statistics RESEARCH funding HYPOTENSION PEPTIDE hormones DATA analysis DATA analysis software HEART failure PATIENT safety LONGITUDINAL method EVALUATION |
| Zdroj: | Journal of Geriatric Cardiology; Dec2023, Vol. 20 Issue 12, p855-866, 12p |
| Abstrakt: | BACKGROUND It is not clear whether sacubitril/valsartan is beneficial for patients with heart failure (HF) with reduced ejection fraction (HFrEF) and low systolic blood pressure (SBP). This study aimed to investigate the efficacy and tolerability of sacubitril/valsartan in HFrEF patients with SBP < 100 mmHg. METHODS & RESULTS An observational study was conducted on 117 patients, 40.2% of whom had SBP < 100 mmHg without symptomatic hypotension, and 59.8% of whom had SBP = 100 mmHg in an optimized HF follow-up management system. At the 6-month follow-up, 52.4% of patients with SBP < 100 mmHg and 70.0% of those with SBP = 100 mmHg successfully reached the target dosages of sacubitril/valsartan. A reduction in the concentration of N-terminal pro-B-type natriuretic peptide was similar between patients with SBP < 100 mmHg and SBP = 100 mmHg (1627.5 pg/mL and 1340.1 pg/mL, respectively; P = 0.75). The effect of sacubitril/valsartan on left ventricular ejection fraction was observed in both SBP categories, with a 10.8% increase in patients with SBP < 100 mmHg (P < 0.001) and a 14.0% increase in patients with SBP = 100 mmHg (P < 0.001). The effects of sacubitril/valsartan on SBP were statistically significant and inverse across both SBP categories (P = 0.001), with an increase of 7.5 mmHg in patients with SBP < 100 mmHg and a decrease of 11.5 mmHg in patients with SBP = 100 mmHg. No statistically significant differences were observed between the two groups in terms of the occurrence of symptomatic hypotension, deteriorating renal function, hyperkalemia, angioedema, or stroke. CONCLUSIONS Within an optimized HF follow-up management system, sacubitril/valsartan exhibited excellent tolerability and prompted left ventricular reverse remodeling in patients with HFrEF who presented asymptomatic hypotension. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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