The efficacy and safety of sacubitril/valsartan in heart failure with reduced ejection fraction patients with hypotension.
Heart failure with reduced ejection fraction
Hypotension
N-terminal pro-B-type natriuretic peptide values
Sacubitril/valsartan
Journal
Heart and vessels
ISSN: 1615-2573
Titre abrégé: Heart Vessels
Pays: Japan
ID NLM: 8511258
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
02
02
2023
accepted:
21
06
2023
medline:
26
9
2023
pubmed:
29
6
2023
entrez:
29
6
2023
Statut:
ppublish
Résumé
Despite previous studies showing that patients with low systolic blood pressure (sBP) in heart failure with reduced ejection fraction (HFrEF) has a poor prognosis, it has few treatment options. This study aimed to investigate the efficacy and safety of sacubitril/valsartan (S/V) in HFrEF patients with hypotension. We included 43 consecutive HFrEF patients with sBP < 100 mmHg despite guideline-directed medical therapy for at least 3 months and who received S/V between September 2020 and July 2021. Patients admitted for acute heart failure were excluded and 29 patients were evaluated for safety endpoints. Furthermore, patients who performed non-pharmacological therapy or died within 1 month were excluded, finally, 25 patients were evaluated for efficacy endpoints. The mean initial S/V dose was 53.0 ± 20.5 mg/day and the mean dosage was increased to 84.0 ± 34.5 mg/day in 1 month. Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) values significantly decreased from 2200 [interquartile range (IQR): 1462-3666] pg/ml to 1409 (IQR: 964-2451) pg/ml. (p < 0.0001). No significant change in sBP occurred (pre-sBP: 93.2 ± 4.9 mmHg, post-sBP: 93.4 ± 9.6 mmHg, p = 0.91), and no patients discontinued the S/V due to symptomatic hypotension in 1 month after S/V initiation. S/V can be safely introduced in HFrEF patients with hypotension to reduce serum NT-proBNP values. Thus, S/V may be useful for the treatment of HFrEF patients with hypotension.
Identifiants
pubmed: 37382703
doi: 10.1007/s00380-023-02283-4
pii: 10.1007/s00380-023-02283-4
doi:
Substances chimiques
sacubitril
17ERJ0MKGI
Tetrazoles
0
Valsartan
80M03YXJ7I
Drug Combinations
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1337-1343Informations de copyright
© 2023. Springer Nature Japan KK, part of Springer Nature.
Références
Conrad N, Judge A, Tran J, Mohseni H, Hedgecott D, Crespillo AP, Allison M, Hemingway H, Cleland JG, McMurray JJV, Rahimi K (2018) Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals. Lancet 391:572–580
doi: 10.1016/S0140-6736(17)32520-5
pubmed: 29174292
pmcid: 5814791
Okura Y, Ramadan MM, Ohno Y, Mitsuma W, Tanaka K, Ito M, Suzuki K, Tanabe N, Kodama M, Aizawa Y (2008) Impending epidemic Future projection of heart failure in Japan to the year 2055. Circ J 72:489–491
doi: 10.1253/circj.72.489
pubmed: 18296852
Dharmarajan K, Rich MW (2017) Epidemiology, pathophysiology, and prognosis of heart failure in older adults. Heart Fail Clin 13:417–426
doi: 10.1016/j.hfc.2017.02.001
pubmed: 28602363
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Celutkiene J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S (2021) 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 42:3599–3726
doi: 10.1093/eurheartj/ehab368
pubmed: 34447992
Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW (2022) 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 79:e263–e421
doi: 10.1016/j.jacc.2021.12.012
pubmed: 35379503
Shirakabe A, Matsushita M, Sawatani T, Noma S, Takayasu T (2023) Effect of sacubitril/valsartan on natriuretic peptide in patients with compensated heart failure. Heart Vessels. https://doi.org/10.1007/s00380-022-02230-9
doi: 10.1007/s00380-022-02230-9
pubmed: 36656354
Komajda M, Anker SD, Cowie MR, Filippatos GS, Mengelle B, Ponikowski P, Tavazzi L (2016) Physicians’ adherence to guideline-recommended medications in heart failure with reduced ejection fraction: data from the QUALIFY global survey. Eur J Heart Fail 18:514–522
doi: 10.1002/ejhf.510
pubmed: 27095461
Setoguchi N, Horiuchi Y, Kawakami T, Nakase M, Watanabe Y, Ishizawa T, Sekiguchi M, Nakajima M, Nonaka H, Asami M, Yahagi K, Komiyama K, Yuzawa H, Tanaka J, Aoki J, Tanabe K (2023) Diuretic and renal effects of angiotensin receptor-neprilysin inhibitor in patients hospitalized for acute heart failure. Heart Vessels. https://doi.org/10.1007/s00380-023-02253-w
doi: 10.1007/s00380-023-02253-w
pubmed: 36854753
McMurray JJ, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, Rouleau JL, Shi VC, Solomon SD, Swedberg K, Zile MR (2014) Angiotensin–neprilysin inhibition versus enalapril in heart failure. N Engl J Med 371:993–1004
doi: 10.1056/NEJMoa1409077
pubmed: 25176015
McMurray JJV, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, Rouleau J, Shi VC, Solomon SD, Swedberg K, Zile MR (2013) Dual angiotensin receptor and neprilysin inhibition as an alternative to angiotensin-converting enzyme inhibition in patients with chronic systolic heart failure: rationale for and design of the prospective comparison of ARNI with ACEI to determine impact. Eur J Heart Fail 15:1062–1073
doi: 10.1093/eurjhf/hft052
pubmed: 23563576
pmcid: 3746839
Masson S, Latini R, Anand IS, Barlera S, Angelici L, Vago T, Tognoni G, Cohn JN (2008) Prognostic value of changes in N-terminal pro-brain natriuretic peptide in Val-HeFT (Valsartan Heart Failure Trial). J Am Coll Cardiol 52:997–1003
doi: 10.1016/j.jacc.2008.04.069
pubmed: 18786480
Januzzi JL, Rehman SU, Mohammed AA, Bhardwaj A, Barajas L, Barajas J, Kim HN, Baggish AL, Weiner RB, Chen-Tournoux A, Marshall JE, Moore SA, Carlson WD, Lewis GD, Shin J, Sullivan D, Parks K, Wang TJ, Gregory SA, Uthamalingam S, Semigran MJ (2011) Use of amino-terminal ProB-type natriuretic peptide to guide outpatient therapy of patients with chronic left ventricular systolic dysfunction. J Am Coll Cardiol 58:1881–1889
doi: 10.1016/j.jacc.2011.03.072
pubmed: 22018299
Velazquez EJ, Morrow DA, DeVore AD, Duffy CI, Ambrosy AP, McCague K, Rocha R, Braunwald E (2019) Angiotensin–neprilysin inhibition in acute decompensated heart failure. N Engl J Med 380:539–548
doi: 10.1056/NEJMoa1812851
pubmed: 30415601
Kim H, Oh J, Lee S, Ha J, Yoon M, Chun K, Lee CJ, Park S, Lee SH, Kang SM (2021) Clinical evidence of initiating a very low dose of sacubitril/valsartan : a prospective observational analysis. Sci Rep. https://doi.org/10.1038/s41598-021-95787-w
doi: 10.1038/s41598-021-95787-w
pubmed: 34963690
pmcid: 8714822
Kramer DG, Trikalinos TA, Kent DM, Antonopoulos GV, Konstam MA, Udelson JE (2010) Quantitative evaluation of drug or device effects on ventricular remodeling as predictors of therapeutic effects on mortality in patients with heart failure and reduced ejection fraction: a meta-analytic approach. J Am Coll Cardiol 56:392–406
doi: 10.1016/j.jacc.2010.05.011
pubmed: 20650361
pmcid: 4523221
Januzzi JL, Prescott MF, Butler J, Felker GM, Maisel AS, McCague K, Camacho A, Pinã IL, Rocha RA, Shah AM, Williamson KM, Solomon SD (2019) Association of change in n-terminal pro-b-type natriuretic peptide following initiation of sacubitril–valsartan treatment with cardiac structure and function in patients with heart failure with reduced ejection fraction. JAMA 322:1085–1095
doi: 10.1001/jama.2019.12821
pubmed: 31475295
pmcid: 6724151
Böhm M, Young R, Jhund PS, Solomon SD, Gong J, Lefkowitz MP, Rizkala AR, Rouleau JL, Shi VC, Swedberg K, Zile MR, Packer M, McMurray JJV (2017) Systolic blood pressure, cardiovascular outcomes and efficacy and safety of sacubitril/ valsartan (LCZ696) in patients with chronic heart failure and reduced ejection fraction: Results from PARADIGM-HF. Eur Heart J 38:1132–1143
doi: 10.1093/eurheartj/ehw570
pubmed: 28158398
pmcid: 6251522
Desai AS, Solomon S, Claggett B, McMurray JJV, Rouleau J, Swedberg K, Zile M, Lefkowitz M, Shi V, Packer M (2016) Factors associated with noncompletion during the run-in period before randomization and influence on the estimated benefit of LCZ696 in the PARADIGM-HF trial. Circ Heart Fail. https://doi.org/10.1161/CIRCHEARTFAILURE.115.002735
doi: 10.1161/CIRCHEARTFAILURE.115.002735
pubmed: 27296397
pmcid: 4718182
Pascual-Figal D, Wachter R, Senni M, Bao W, Noè A, Schwende H, Butylin D, Prescott MF (2020) NT-proBNP response to sacubitril/valsartan in hospitalized heart failure patients with reduced ejection fraction: TRANSITION study. J Am Coll Cardiol HF 8:822–833
Cautela J, Tartiere JM, Cohen-Solal A, Bellemain-Appaix A, Theron A, Tibi T, Januzzi JL, Roubille F, Girerd N (2020) Management of low blood pressure in ambulatory heart failure with reduced ejection fraction patients. Eur J Heart Fail 22:1357–1365
doi: 10.1002/ejhf.1835
pubmed: 32353213