Cargando…

Effectiveness and Safety of Sacubitril/Valsartan in Patients with Chronic Kidney Disease—A Real-World Experience

Background: data regarding the effectiveness and safety of sacubitril/valsartan in heart failure and reduced ejection fraction (HFrEF) patients with chronic kidney disease (CKD) are scarse. Objective: to evaluate the effectiveness and safety of sacubitril/valsartan in HFrEF and CKD in a real-world p...

Descripción completa

Detalles Bibliográficos
Autores principales: Pereira, Sara C., Rodrigues, Tiago, Nunes-Ferreira, Afonso, Agostinho, João R., Pinto, Fausto J., Brito, Dulce
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967392/
https://www.ncbi.nlm.nih.gov/pubmed/36835870
http://dx.doi.org/10.3390/jcm12041334
_version_ 1784897252908597248
author Pereira, Sara C.
Rodrigues, Tiago
Nunes-Ferreira, Afonso
Agostinho, João R.
Pinto, Fausto J.
Brito, Dulce
author_facet Pereira, Sara C.
Rodrigues, Tiago
Nunes-Ferreira, Afonso
Agostinho, João R.
Pinto, Fausto J.
Brito, Dulce
author_sort Pereira, Sara C.
collection PubMed
description Background: data regarding the effectiveness and safety of sacubitril/valsartan in heart failure and reduced ejection fraction (HFrEF) patients with chronic kidney disease (CKD) are scarse. Objective: to evaluate the effectiveness and safety of sacubitril/valsartan in HFrEF and CKD in a real-world population. Methods: we included consecutive ambulatory HFrEF patients that initiated sacubitril/valsartan between February 2017 and October 2020, stratified by CKD (KDIGO stage 5 excluded). Primary outcomes: the incidence rate per 100 patient-years and the annualized length of stay (LOS) of acute decompensated HF hospitalizations (HFH). Secondary outcomes: all-cause mortality, NYHA improvement, and titration of sacubitril/valsartan. Results: We included 179 patients, 77 with CKD, those being older (72 ± 10 vs. 65 ± 12 years, p < 0.001), had higher NT-proBNP (4623 ± 5266 vs. 1901 ± 1835 pg/mL, p < 0.001), and high anaemia incidence (p < 0.001). After 19 ± 11 months, a significant reduction in HFH adjusted incidence rate (57.5% decrease in CKD vs. 74.6%, p = 0.261) was observed, with 5 days there was a reduction in annualized LOS in both groups (p = 0.319). NYHA improved similarly in both groups (p = 0.670). CKD patients presented non-significant higher all-cause mortality (HR = 2.405, 95%CI: [0.841; 6.879], p = 0.102). Both groups had similar sacubitril/valsartan maximum dose achievement and drug withdrawal. Conclusion: sacubitril/valsartan was effective on reducing HFH and LOS without affecting all-cause mortality in a CKD real-world population.
format Online
Article
Text
id pubmed-9967392
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99673922023-02-26 Effectiveness and Safety of Sacubitril/Valsartan in Patients with Chronic Kidney Disease—A Real-World Experience Pereira, Sara C. Rodrigues, Tiago Nunes-Ferreira, Afonso Agostinho, João R. Pinto, Fausto J. Brito, Dulce J Clin Med Article Background: data regarding the effectiveness and safety of sacubitril/valsartan in heart failure and reduced ejection fraction (HFrEF) patients with chronic kidney disease (CKD) are scarse. Objective: to evaluate the effectiveness and safety of sacubitril/valsartan in HFrEF and CKD in a real-world population. Methods: we included consecutive ambulatory HFrEF patients that initiated sacubitril/valsartan between February 2017 and October 2020, stratified by CKD (KDIGO stage 5 excluded). Primary outcomes: the incidence rate per 100 patient-years and the annualized length of stay (LOS) of acute decompensated HF hospitalizations (HFH). Secondary outcomes: all-cause mortality, NYHA improvement, and titration of sacubitril/valsartan. Results: We included 179 patients, 77 with CKD, those being older (72 ± 10 vs. 65 ± 12 years, p < 0.001), had higher NT-proBNP (4623 ± 5266 vs. 1901 ± 1835 pg/mL, p < 0.001), and high anaemia incidence (p < 0.001). After 19 ± 11 months, a significant reduction in HFH adjusted incidence rate (57.5% decrease in CKD vs. 74.6%, p = 0.261) was observed, with 5 days there was a reduction in annualized LOS in both groups (p = 0.319). NYHA improved similarly in both groups (p = 0.670). CKD patients presented non-significant higher all-cause mortality (HR = 2.405, 95%CI: [0.841; 6.879], p = 0.102). Both groups had similar sacubitril/valsartan maximum dose achievement and drug withdrawal. Conclusion: sacubitril/valsartan was effective on reducing HFH and LOS without affecting all-cause mortality in a CKD real-world population. MDPI 2023-02-07 /pmc/articles/PMC9967392/ /pubmed/36835870 http://dx.doi.org/10.3390/jcm12041334 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pereira, Sara C.
Rodrigues, Tiago
Nunes-Ferreira, Afonso
Agostinho, João R.
Pinto, Fausto J.
Brito, Dulce
Effectiveness and Safety of Sacubitril/Valsartan in Patients with Chronic Kidney Disease—A Real-World Experience
title Effectiveness and Safety of Sacubitril/Valsartan in Patients with Chronic Kidney Disease—A Real-World Experience
title_full Effectiveness and Safety of Sacubitril/Valsartan in Patients with Chronic Kidney Disease—A Real-World Experience
title_fullStr Effectiveness and Safety of Sacubitril/Valsartan in Patients with Chronic Kidney Disease—A Real-World Experience
title_full_unstemmed Effectiveness and Safety of Sacubitril/Valsartan in Patients with Chronic Kidney Disease—A Real-World Experience
title_short Effectiveness and Safety of Sacubitril/Valsartan in Patients with Chronic Kidney Disease—A Real-World Experience
title_sort effectiveness and safety of sacubitril/valsartan in patients with chronic kidney disease—a real-world experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967392/
https://www.ncbi.nlm.nih.gov/pubmed/36835870
http://dx.doi.org/10.3390/jcm12041334
work_keys_str_mv AT pereirasarac effectivenessandsafetyofsacubitrilvalsartaninpatientswithchronickidneydiseasearealworldexperience
AT rodriguestiago effectivenessandsafetyofsacubitrilvalsartaninpatientswithchronickidneydiseasearealworldexperience
AT nunesferreiraafonso effectivenessandsafetyofsacubitrilvalsartaninpatientswithchronickidneydiseasearealworldexperience
AT agostinhojoaor effectivenessandsafetyofsacubitrilvalsartaninpatientswithchronickidneydiseasearealworldexperience
AT pintofaustoj effectivenessandsafetyofsacubitrilvalsartaninpatientswithchronickidneydiseasearealworldexperience
AT britodulce effectivenessandsafetyofsacubitrilvalsartaninpatientswithchronickidneydiseasearealworldexperience