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Outcomes of Heart Failure with Reduced Ejection Fraction Patients Receiving Sacubitril/Valsartan in Real-World Practice

Panyapat Jiampo¹, Theeravet Pattayanant², Pornthip Yoonaisil³, Pawana Watansawad⁴

Affiliation : ¹ Division of Cardiology, Department of Medicine, Bhumibol Adulyadej Hospital, Bangkok, Thailand, ² Department of Medicine, Bangchak Hospital, Bangkok, Thailand, ³ Department of Nutrition Center, Phyathai 3 Hospital, Bangkok, Thailand, ⁴ Bhumibol Adulyadej Hospital, Bangkok, Thailand

Objective: To describe clinical outcomes and NT-pro-brain natriuretic peptide (NT-proBNP) level of patients with chronic heart failure with reduced ejection fraction (HFrEF) receiving sacubitril/valsartan (Sac/Val) in real world setting.
Materials and Methods: The present research was a single-center, retrospective, non-interventional study in adult patients with HFrEF that received Sac/Val at Bhumibol Adulyadej Hospital. Data were extracted from the hospital’s database and electronic medical records. All patients fulfilling the inclusion criteria were identified and included into the present study. The present study was approved by the Ethics Committees of Bhumibol Adulyadej Hospital.
Results: During the two years of the present study, two patients died from cardiovascularly (CV) death. The New York Heart Association (NYHA) class was changed from baseline to 12-month (2.0±0.4) and 24-month (1.8±0.1), p<0.001. Left ventricular ejection fraction (LVEF) was significantly inclined at 24-month compared to baseline. The rate of heart failure and related hospitalization within one year declined from baseline at 19 visits/year to 12-month at 6 visits/year, and 24-month at 5 visits/year. The mean of NT-proBNP level was significantly reduced from baseline at 2,802.3±3,106.7 to 12-month at 2,203.8±4,051.1, and 24-month at 1,157.6±1,069.9 (p=0.03). Total hospitalization due to any cause was decreased from baseline at 26 visits/year to 12-month at 24 visits/year, and 24-month at 12 visits/year. Numbers of emergency room visit, ICU/CCU admission, length of stay for admission, and direct medical cost of heart failure (HF) treatment were diminished from baseline.
Conclusion: Sac/Val can reduce hospitalized HF and level of NT-proBNP. Its efficiency in Thai patients with HFrEF was similar to real world data.

Received 2 May 2022 | Revised 27 June 2022 | Accepted 8 July 2022
DOI: 10.35755/jmedassocthai.2022.09.13478

Keywords : Heart Failure with reduced ejection fraction, Sacubitril/Valsartan, Angiotensin receptor blocker/neprilysin inhibitor (ARNI)


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