Abstract:
BACKGROUND:Angiotensin receptor and neprilysin inhibition (ARNI) has been shown to reduce cardiovascular mortality by 20% as compared with enalapril in a randomized controlled trial. However, there is a paucity of real-world data on the effects of ARNI in heart failure patients with reduced ejection fraction (HFrEF), especially those with concurrent renal impairment or hypotension. METHODS:Between 2016 and 2017, we recruited 466 HFrEF patients treated with sacubitril/valsartan (Group A) and 466 patients managed with standard HF treatment without ARNI (Group B) in a HF referral center. Baseline characteristics and clinical outcomes were collected between both groups. RESULTS:Baseline characteristics were comparable between the two groups. During a follow-up period of 15 months, death from cardiovascular causes or first unplanned hospitalization for HF occurred in 100 patients in Group A (21.5%) and 144 in Group B (30.9%, hazard ratio 0.66; 95% CI 0.51-0.85; p=0.001). The incidences of deaths from any causes, cardiovascular death, sudden death, and HF re-hospitalization were all significantly lower in Group A than Group B patients. Among patients with different chronic kidney disease stages and normotensive patients, treatment with sacubitril/valsartan showed more favorable outcomes than treatment with standard HF care without ARNI. However, in patients with baseline systolic blood pressure lower than 100mmHg, there were no significant differences of outcomes in both groups. Among Group A patients, escalation of sacubitril/valsartan was associated with better outcomes. CONCLUSIONS:Our study demonstrated the effectiveness of sacubitril/valsartan on HFrEF patients in real world practice, including those with advanced renal impairment.
journal_name
J Cardioljournal_title
Journal of cardiologyauthors
Chang HY,Feng AN,Fong MC,Hsueh CW,Lai WT,Huang KC,Chong E,Chen CN,Chang HC,Yin WHdoi
10.1016/j.jjcc.2019.03.010subject
Has Abstractpub_date
2019-10-01 00:00:00pages
372-380issue
4eissn
0914-5087issn
1876-4738pii
S0914-5087(19)30082-6journal_volume
74pub_type
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doi:
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journal_title:Journal of cardiology
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doi:
更新日期:2006-09-01 00:00:00
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pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
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doi:10.1016/j.jjcc.2008.06.002
更新日期:2008-12-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1016/j.jjcc.2011.10.005
更新日期:2012-03-01 00:00:00
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doi:10.1016/j.jjcc.2013.11.014
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doi:
更新日期:1997-06-01 00:00:00
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更新日期:1992-01-01 00:00:00
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更新日期:2000-09-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2015.08.010
更新日期:2016-07-01 00:00:00
abstract::Functional mitral regurgitation (MR) has been traditionally known as secondary MR resulting from left ventricular (LV) dilatation and systolic dysfunction. However, deterioration of functional MR also relates to mitral annular (MA) dilatation. Furthermore, MA dilatation due to left atrial dilatation in patients with a...
journal_title:Journal of cardiology
pub_type: 杂志文章,评审
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journal_title:Journal of cardiology
pub_type: 杂志文章,多中心研究
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更新日期:2015-12-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2019.08.014
更新日期:2020-04-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2019.11.002
更新日期:2020-05-01 00:00:00