Effects of sacubitril/valsartan on renal function and outcome in patients with heart failure and reduced ejection fraction: an Italian cohort study

Autor: Alberto Palazzuoli, Filippo Pirrotta, Alessandra Cartocci, Elvira Delcuratolo, Frank Loyd Dini, Michele Correale, Giuseppe Dattilo, Daniele Masarone, Laura Scelsi, Stefano Ghio, Carlo Gabriele Tocchetti, Valentina Mercurio, Natale Daniele Brunetti, Savina Nodari, Francesco Barillà, Giuseppe Ambrosio, Erberto Carluccio
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Therapeutic Advances in Cardiovascular Disease, Vol 18 (2024)
Druh dokumentu: article
ISSN: 1753-9455
17539447
DOI: 10.1177/17539447241285136
Popis: Background: Sacubitril/valsartan (S/V) is a cornerstone treatment for heart failure (HF). Beneficial effects on hospitalization rates, mortality, and left ventricular remodeling have been observed in patients with heart failure and reduced ejection fraction (HFrEF). Despite the positive results, the influence of S/V on renal function during long-term follow-up has received little attention. Aims: We investigated the long-term effects of S/V therapy on renal function in a large cohort of patients with HFrEF. Additionally, we examined the effects of the drug in patients with chronic kidney disease (CKD) compared to those with preserved renal function and identified primary risk characteristics Methods: We studied 776 outpatients with HFrEF and left ventricular ejection fraction (LVEF) 1000 pg/ml (HR 1.95[1.38, 2.77], p < 0.001), furosemide dose >50 mg (HR 2.04 [1.48, 2.82], p < 0.001), and creatinine values >1.5 mg/dl occurred during follow-up (HR 1.74 [1.24, 2.43], p < 0.001) were linked to increased risk. At multivariable analysis, increased doses of loop diuretics, advanced NYHA class, creatinine >1.5 mg/dl, and atrial fibrillation were independent predictors of adverse events. Conclusion: Long-term S/V therapy is associated with improved outcomes and renal protection in patients with HFrEF. This effect is more pronounced in patients who tolerate escalating doses. The positive effects of the drug are maintained in both CKD and preserved renal function. Future research may study the safety and underlying causes of current protection.
Databáze: Directory of Open Access Journals
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