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Prescription of sacubitril/valsartan in patients with heart failure and reduced ejection fraction attending to an outpatient heart failure clinic

M. Rizzo1, I. Colomer-Asenjo1, M. Sutil-Vega1, G. Cabello-Molina1, S. Marín-López1, F. Taibi-Hajjami1, C. Roca-Guerrero1, D. García-Vega1, M. Panelo-Rubio1, M. Bonastre-Thio1, A. Martínez-Rubio1 (1Sabadell (Barcelona) ES)


Aims: To assess the clinical and neurohormonal characteristics of patients eligible to sacubitril/valsartan (SV) attending to an outpatient heart failure clinic and describe variables related to SV prescription in real life heart failure patients.

Design & methods: We collected data from 119 consecutive patients attending to our heart failure outpatient clinic between May 2018 and November 2018.

Results: At baseline, mean age was 64±10 years and 75,5% were men. Mean LVEF was 28±6%. 42% ischemic etiology. 83 patients (70%) NYHA class II. Median NT-proBNP was 1288 pg/ml (IQR 377-3967), mean glomerular filtration rate (GFR) 67,0±22,8 mL/min and potassium 4,5±0,4 mEq/L. 85% of patients were treated with ACE inhibitors or angiotensin receptor blockers. 96% received β-blockers and 86% mineralocorticoid receptor antagonists. Of this 119 eligible patients, 64 (53,8%) were treated with SV. Achieving >50% of β-blocker target dose, TFG ≥ 60 mL/min and systolic blood pressure (SBP) ≥110 mmHg were significantly associated with the prescription of SV. In a multivariate analysis adjusted for age and β-blockers dose, a higher SBP (OR 1,26 95%CI 1,16-2,01) and GFR (OR 1.02 95%CI 1.01-1.14) were independently associated with the prescription of SV.

Conclusions: The rate of prescription of SV in our cohort is relatively higher than in other real life registries. Low SBP and TFG suggest a subgroup of patients with higher risk of adverse events, requiring an optimization of concomitant treatment, mainly diuretics and vasodilators, leading to higher rate of SV prescription.

    
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Aims: To assess the clinical and neurohormonal characteristics of patients eligible to sacubitril/valsartan (SV) attending to an outpatient heart failure clinic and describe variables related to SV prescription in real life heart failure patients.

Design & methods: We collected data from 119 consecutive patients attending to our heart failure outpatient clinic between May 2018 and November 2018.

Results: At baseline, mean age was 64±10 years and 75,5% were men. Mean LVEF was 28±6%. 42% ischemic etiology. 83 patients (70%) NYHA class II. Median NT-proBNP was 1288 pg/ml (IQR 377-3967), mean glomerular filtration rate (GFR) 67,0±22,8 mL/min and potassium 4,5±0,4 mEq/L. 85% of patients were treated with ACE inhibitors or angiotensin receptor blockers. 96% received β-blockers and 86% mineralocorticoid receptor antagonists. Of this 119 eligible patients, 64 (53,8%) were treated with SV. Achieving >50% of β-blocker target dose, TFG ≥ 60 mL/min and systolic blood pressure (SBP) ≥110 mmHg were significantly associated with the prescription of SV. In a multivariate analysis adjusted for age and β-blockers dose, a higher SBP (OR 1,26 95%CI 1,16-2,01) and GFR (OR 1.02 95%CI 1.01-1.14) were independently associated with the prescription of SV.

Conclusions: The rate of prescription of SV in our cohort is relatively higher than in other real life registries. Low SBP and TFG suggest a subgroup of patients with higher risk of adverse events, requiring an optimization of concomitant treatment, mainly diuretics and vasodilators, leading to higher rate of SV prescription.

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Marcelo Rizzo
ES-08208 Sabadell (Barcelona)
marcelo.rxo@gmail.com ) [session] => stdClass Object ( [id] => 1 [name] => Poster [date] => 2019-05-09 [start] => 00:00:00 [end] => 00:00:00 [abbr] => P [updated] => [created] => 0000-00-00 00:00:00 ) [formatted_authors] => M. Rizzo1, I. Colomer-Asenjo1, M. Sutil-Vega1, G. Cabello-Molina1, S. Marín-López1, F. Taibi-Hajjami1, C. Roca-Guerrero1, D. García-Vega1, M. Panelo-Rubio1, M. Bonastre-Thio1, A. Martínez-Rubio1 (1Sabadell (Barcelona) ES) [detail_url] => https://www.iscp2019.com/abstracts/presentation/20 )