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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2023
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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 |
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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 |
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