Clinical outcomes of Sacubitril/Valsartan in patients with acute heart failure: A multi-institution study
Background: The effectiveness and safety of initiating sacubitril/valsartan therapy among patients who are hospitalized for acute heart failure (HF) is unclear. Methods: A cohort of 3736 patients with HF with reduced ejection fraction (HFrEF) hospitalized for acute HF was identified from Chang Gung...
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2021-11-01
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doaj-ac762de6637047079f83a569ba73edc02021-10-09T04:40:52ZengElsevierEClinicalMedicine2589-53702021-11-0141101149Clinical outcomes of Sacubitril/Valsartan in patients with acute heart failure: A multi-institution studyDong-Yi Chen0Chun-Chi Chen1Chi-Nan Tseng2Shao-Wei Chen3Shang-Hung Chang4Wen-Kuan Huang5Ming-Shien Wen6Ming-Jer Hsieh7I-Chang Hsieh8Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Cardio-Oncology Program, Chang Gung Memorial Hospital Linkou, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou, TaiwanDivision of Hematology/Oncology, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Cardio-Oncology Program, Chang Gung Memorial Hospital Linkou, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Cardio-Oncology Program, Chang Gung Memorial Hospital Linkou, Taoyuan, Taiwan; Corresponding authors.Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Corresponding authors.Background: The effectiveness and safety of initiating sacubitril/valsartan therapy among patients who are hospitalized for acute heart failure (HF) is unclear. Methods: A cohort of 3736 patients with HF with reduced ejection fraction (HFrEF) hospitalized for acute HF was identified from Chang Gung Research Database between January 1, 2016 and August 31, 2019. The risks of rehospitalization for HF and death associated with sacubitril/valsartan therapy compared to angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) therapy were evaluated. We used stabilized inverse probability of treatment weighting to balance the baseline covariates. The risks of fatal and non-fatal outcomes between the groups were compared using a Cox proportional hazard model and Fine and Gray subdistribution hazard model, respectively. Findings: The composite of rehospitalization for HF and death occurred in 22.9% of the patients in the sacubitril/valsartan group compared to 32.6% in the ACEI/ARB group (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.52–0.97) after a mean follow-up period of 11.8 months. The sacubitril/valsartan group had a lower risk of rehospitalization for HF (subdistribution HR 0.83, 95% CI 0.74–0.92) and all-cause death (HR 0.51, 95% CI 0.27–0.94). There were no significant differences in the rates of worsening renal function or severe hyperkalemia between the two groups. Interpretation: In real-world practice, initiating sacubitril/valsartan therapy among patients with HFrEF who were hospitalized for acute HF was associated with a lower rate of rehospitalization for HF and death compared with ACEI/ARB therapy. Funding: This study was supported by Novartis Pharmaceuticals.http://www.sciencedirect.com/science/article/pii/S2589537021004296Sacubitril/ValsartanHear failureHFrEFAngiotensin receptor neprilysin inhibitor (ARNI) |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dong-Yi Chen Chun-Chi Chen Chi-Nan Tseng Shao-Wei Chen Shang-Hung Chang Wen-Kuan Huang Ming-Shien Wen Ming-Jer Hsieh I-Chang Hsieh |
spellingShingle |
Dong-Yi Chen Chun-Chi Chen Chi-Nan Tseng Shao-Wei Chen Shang-Hung Chang Wen-Kuan Huang Ming-Shien Wen Ming-Jer Hsieh I-Chang Hsieh Clinical outcomes of Sacubitril/Valsartan in patients with acute heart failure: A multi-institution study EClinicalMedicine Sacubitril/Valsartan Hear failure HFrEF Angiotensin receptor neprilysin inhibitor (ARNI) |
author_facet |
Dong-Yi Chen Chun-Chi Chen Chi-Nan Tseng Shao-Wei Chen Shang-Hung Chang Wen-Kuan Huang Ming-Shien Wen Ming-Jer Hsieh I-Chang Hsieh |
author_sort |
Dong-Yi Chen |
title |
Clinical outcomes of Sacubitril/Valsartan in patients with acute heart failure: A multi-institution study |
title_short |
Clinical outcomes of Sacubitril/Valsartan in patients with acute heart failure: A multi-institution study |
title_full |
Clinical outcomes of Sacubitril/Valsartan in patients with acute heart failure: A multi-institution study |
title_fullStr |
Clinical outcomes of Sacubitril/Valsartan in patients with acute heart failure: A multi-institution study |
title_full_unstemmed |
Clinical outcomes of Sacubitril/Valsartan in patients with acute heart failure: A multi-institution study |
title_sort |
clinical outcomes of sacubitril/valsartan in patients with acute heart failure: a multi-institution study |
publisher |
Elsevier |
series |
EClinicalMedicine |
issn |
2589-5370 |
publishDate |
2021-11-01 |
description |
Background: The effectiveness and safety of initiating sacubitril/valsartan therapy among patients who are hospitalized for acute heart failure (HF) is unclear. Methods: A cohort of 3736 patients with HF with reduced ejection fraction (HFrEF) hospitalized for acute HF was identified from Chang Gung Research Database between January 1, 2016 and August 31, 2019. The risks of rehospitalization for HF and death associated with sacubitril/valsartan therapy compared to angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) therapy were evaluated. We used stabilized inverse probability of treatment weighting to balance the baseline covariates. The risks of fatal and non-fatal outcomes between the groups were compared using a Cox proportional hazard model and Fine and Gray subdistribution hazard model, respectively. Findings: The composite of rehospitalization for HF and death occurred in 22.9% of the patients in the sacubitril/valsartan group compared to 32.6% in the ACEI/ARB group (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.52–0.97) after a mean follow-up period of 11.8 months. The sacubitril/valsartan group had a lower risk of rehospitalization for HF (subdistribution HR 0.83, 95% CI 0.74–0.92) and all-cause death (HR 0.51, 95% CI 0.27–0.94). There were no significant differences in the rates of worsening renal function or severe hyperkalemia between the two groups. Interpretation: In real-world practice, initiating sacubitril/valsartan therapy among patients with HFrEF who were hospitalized for acute HF was associated with a lower rate of rehospitalization for HF and death compared with ACEI/ARB therapy. Funding: This study was supported by Novartis Pharmaceuticals. |
topic |
Sacubitril/Valsartan Hear failure HFrEF Angiotensin receptor neprilysin inhibitor (ARNI) |
url |
http://www.sciencedirect.com/science/article/pii/S2589537021004296 |
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