Cargando…

Renal effects of Sacubitril/Valsartan in heart failure with reduced ejection fraction: a real life 1-year follow-up study

Real-life data confirming the favourable renal outcome in patients with heart failure (HF) treated with Sacubitril/Valsartan, previously found in several trials (RCTs), are still scant. We evaluated the renal effects of Sacubitril/Valsartan in a real-life sample of HF patients. Observational analysi...

Descripción completa

Detalles Bibliográficos
Autores principales: Spannella, Francesco, Marini, Marco, Giulietti, Federico, Rosettani, Giulia, Francioni, Matteo, Perna, Gian Piero, Sarzani, Riccardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853858/
https://www.ncbi.nlm.nih.gov/pubmed/31147823
http://dx.doi.org/10.1007/s11739-019-02111-6
_version_ 1783470114524364800
author Spannella, Francesco
Marini, Marco
Giulietti, Federico
Rosettani, Giulia
Francioni, Matteo
Perna, Gian Piero
Sarzani, Riccardo
author_facet Spannella, Francesco
Marini, Marco
Giulietti, Federico
Rosettani, Giulia
Francioni, Matteo
Perna, Gian Piero
Sarzani, Riccardo
author_sort Spannella, Francesco
collection PubMed
description Real-life data confirming the favourable renal outcome in patients with heart failure (HF) treated with Sacubitril/Valsartan, previously found in several trials (RCTs), are still scant. We evaluated the renal effects of Sacubitril/Valsartan in a real-life sample of HF patients. Observational analysis of 54 consecutive outpatients affected by HF with reduced ejection fraction (HFrEF) and clinical indication for Sacubitril/Valsartan. Patients were evaluated at baseline (T0) and after six (T6) and twelve (T12) months after initiating Sacubitril/Valsartan and compared with a group of 30 historical controls. Mean age: 65.5 ± 11.7 years. Older patients: 29 (53.7%). Mean baseline estimated glomerular filtration rate (eGFR): 59.4 ± 19.2 ml/min/1.73 m(2). Patients with chronic kidney disease (CKD), defined by an eGFR < 60 ml/min/1.73 m(2), were 29 (53.7%). Sacubitril/Valsartan was less titrated in both older patients and patients with CKD. There were no changes in diuretics during follow-up. Systolic blood pressure (BP) decreased during follow-up (p = 0.014), while left ventricular ejection fraction (LVEF) slighly increased (p < 0.001). Renal function improved after 12 months compared to historical controls (p for interaction < 0.001) and a greater benefit was found in subjects aged < 65 years (p for interaction = 0.002) and patients with CKD (p for interaction = 0.009). A statistically (p = 0.009), but not clinically significant increase in serum potassium was also found, regardless of age and CKD. This is the first study focused on the renal effects of Sacubitril/Valsartan in HFrEF patients followed for 12 months in a real-life clinical context. The improved eGFR, despite lower BP, represents an important confirmation outside the peculiar world of RCTs.
format Online
Article
Text
id pubmed-6853858
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Springer International Publishing
record_format MEDLINE/PubMed
spelling pubmed-68538582019-12-12 Renal effects of Sacubitril/Valsartan in heart failure with reduced ejection fraction: a real life 1-year follow-up study Spannella, Francesco Marini, Marco Giulietti, Federico Rosettani, Giulia Francioni, Matteo Perna, Gian Piero Sarzani, Riccardo Intern Emerg Med Im - Original Real-life data confirming the favourable renal outcome in patients with heart failure (HF) treated with Sacubitril/Valsartan, previously found in several trials (RCTs), are still scant. We evaluated the renal effects of Sacubitril/Valsartan in a real-life sample of HF patients. Observational analysis of 54 consecutive outpatients affected by HF with reduced ejection fraction (HFrEF) and clinical indication for Sacubitril/Valsartan. Patients were evaluated at baseline (T0) and after six (T6) and twelve (T12) months after initiating Sacubitril/Valsartan and compared with a group of 30 historical controls. Mean age: 65.5 ± 11.7 years. Older patients: 29 (53.7%). Mean baseline estimated glomerular filtration rate (eGFR): 59.4 ± 19.2 ml/min/1.73 m(2). Patients with chronic kidney disease (CKD), defined by an eGFR < 60 ml/min/1.73 m(2), were 29 (53.7%). Sacubitril/Valsartan was less titrated in both older patients and patients with CKD. There were no changes in diuretics during follow-up. Systolic blood pressure (BP) decreased during follow-up (p = 0.014), while left ventricular ejection fraction (LVEF) slighly increased (p < 0.001). Renal function improved after 12 months compared to historical controls (p for interaction < 0.001) and a greater benefit was found in subjects aged < 65 years (p for interaction = 0.002) and patients with CKD (p for interaction = 0.009). A statistically (p = 0.009), but not clinically significant increase in serum potassium was also found, regardless of age and CKD. This is the first study focused on the renal effects of Sacubitril/Valsartan in HFrEF patients followed for 12 months in a real-life clinical context. The improved eGFR, despite lower BP, represents an important confirmation outside the peculiar world of RCTs. Springer International Publishing 2019-05-30 2019 /pmc/articles/PMC6853858/ /pubmed/31147823 http://dx.doi.org/10.1007/s11739-019-02111-6 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Im - Original
Spannella, Francesco
Marini, Marco
Giulietti, Federico
Rosettani, Giulia
Francioni, Matteo
Perna, Gian Piero
Sarzani, Riccardo
Renal effects of Sacubitril/Valsartan in heart failure with reduced ejection fraction: a real life 1-year follow-up study
title Renal effects of Sacubitril/Valsartan in heart failure with reduced ejection fraction: a real life 1-year follow-up study
title_full Renal effects of Sacubitril/Valsartan in heart failure with reduced ejection fraction: a real life 1-year follow-up study
title_fullStr Renal effects of Sacubitril/Valsartan in heart failure with reduced ejection fraction: a real life 1-year follow-up study
title_full_unstemmed Renal effects of Sacubitril/Valsartan in heart failure with reduced ejection fraction: a real life 1-year follow-up study
title_short Renal effects of Sacubitril/Valsartan in heart failure with reduced ejection fraction: a real life 1-year follow-up study
title_sort renal effects of sacubitril/valsartan in heart failure with reduced ejection fraction: a real life 1-year follow-up study
topic Im - Original
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853858/
https://www.ncbi.nlm.nih.gov/pubmed/31147823
http://dx.doi.org/10.1007/s11739-019-02111-6
work_keys_str_mv AT spannellafrancesco renaleffectsofsacubitrilvalsartaninheartfailurewithreducedejectionfractionareallife1yearfollowupstudy
AT marinimarco renaleffectsofsacubitrilvalsartaninheartfailurewithreducedejectionfractionareallife1yearfollowupstudy
AT giuliettifederico renaleffectsofsacubitrilvalsartaninheartfailurewithreducedejectionfractionareallife1yearfollowupstudy
AT rosettanigiulia renaleffectsofsacubitrilvalsartaninheartfailurewithreducedejectionfractionareallife1yearfollowupstudy
AT francionimatteo renaleffectsofsacubitrilvalsartaninheartfailurewithreducedejectionfractionareallife1yearfollowupstudy
AT pernagianpiero renaleffectsofsacubitrilvalsartaninheartfailurewithreducedejectionfractionareallife1yearfollowupstudy
AT sarzaniriccardo renaleffectsofsacubitrilvalsartaninheartfailurewithreducedejectionfractionareallife1yearfollowupstudy