Safety and Efficacy of the Combination of Sacubitril/Valsartan and SGLT2i in HFrEF Patients (SECSI Registry)
Autor: | José Luis Zamorano Gómez, Susana Del Prado Díaz, Jara Gayán Ordás, Ramón Bascompte Claret, Alfonso Valle, Julia Seller Moya, Herminio Morillas Climent, Marta Jiménez-Blanco Bravo, David Cordero Pereda, Gonzalo Luis Alonso Salinas |
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Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_specialty New York Heart Association Class Time Factors Kidney Sacubitril Ventricular Function Left Internal medicine medicine Clinical endpoint Humans Protease Inhibitors Registries Renal Insufficiency Chronic Sodium-Glucose Transporter 2 Inhibitors Aged Retrospective Studies Pharmacology Aged 80 and over Ejection fraction business.industry Aminobutyrates Biphenyl Compounds Stroke Volume Middle Aged medicine.disease Drug Combinations Treatment Outcome Valsartan Spain Heart failure Female Neprilysin Cardiology and Cardiovascular Medicine business Angiotensin II Type 1 Receptor Blockers Sacubitril Valsartan medicine.drug Kidney disease Glomerular Filtration Rate Heart Failure Systolic |
Zdroj: | Journal of cardiovascular pharmacology. 78(5) |
ISSN: | 1533-4023 |
Popis: | Recent studies have proven benefit of SGLT2i drugs in patients with heart failure with reduced ejection fraction (HFrEF), but their safety when combined with angiotensin-neprilysin inhibitor (ARNI) has not been established. The Safety and Efficacy of the Combination of Sacubitril/Valsartan and SGLT2i in HFrEF Patients registry was conducted to address this issue. SECSI registry is a consecutive, observational, retrospective, multicentre study conducted in 3 Heart Failure Units in Spain. It included 144 HFrEF patients who were treated with ARNI and iSGLT2. Data were collected at baseline, month 2, and month 6. The primary endpoint was the estimated glomerular filtration rate (eGFR), after the initiation of ARNI and sodium-glucose cotransporter-2 inhibitors (SGLT2i). Secondary endpoints included potassium levels and functional class (New York Heart Association class). There were 3 prespecified subgroup analyses: Elderly patients (≥70 years), patients with chronic kidney disease (KDIGO classification G3), and the sequence of drug initiation. Mean age was 69.9 ± 10.1 years, and 110 (76.4%) were men. Left ventricular ejection fraction was 32 ± 7.8%, and most patients were symptomatic [123 (87.2%) New York Heart Association II/III/IV]. eGFR decreased at month 2 and this trend was maintained at month 6 [eGFR baseline 68.5 ± 17.3, month 2 62 ± 19.7 and month 6 64.7 ± 8.6 mL/min/1.73 m2 (P < 0.01 for both)]. In prespecified analysis, elder patients and those who simultaneously initiate both treatments showed the steeper decrease in eGFR. To conclude, co-administration of SGLT2i and ARNI in routine care in HFrEF patients produced a slight decrease in eGFR at 6 months of follow-up. This decrease was especially significant in elder patients and those who initiate both drugs simultaneously. |
Databáze: | OpenAIRE |
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