Effectiveness of sacubitril-varsartan versus angiotensin con-verting enzyme inhibitors in patients hospitalized for acute heart failure: a retrospective cohort study of the RICA registry
Llanos Soler-Rangel1
Manuel Méndez-Bailón2
José Pérez-Silvestre3
JoséMaría Fernández-Rodríguez4
Beatriz Cuesta García4
Adrián Argüelles-Curto4
Álvaro González-Franco5
Alicia Conde-Martel6
Sara Carrascosa-García3
Marta Sánchez-Marteles7
José Manuel Cerqueiro-González8
Noel Lorenzo-Villalba9
Manuel Montero-Pérez-Barquero10
1.Llanos Soler-Rangel,Servicio de Medicina Interna,Hospital Universitario Infanta Sofía,FIIB HUIS HHEN,Madrid,Spain2.Servicio de Medicina Interna,Hospital Clínico San Carlos,Instituto de Investigación San Carlos(IdISSC),Spain3.Servicio de Medicina Interna,Consorcio Hospital General Universitario de Valencia,Spain4.Servicio de Medicina Interna,Hospital Carmen y Severo Ochoa,Cangas del Narcea,Asturias,Spain5.Servicio de Medicina Interna,Hospital Universitario Central de Asturias,Oviedo,Spain6.Servicio de Medicina Interna,Hospital Universitario de Gran Canaria Dr Negrín,Spain7.Servicio de Medicina Interna,Hospital Clínico Universitario Lozano Blesa de Zaragoza,Zaragoza,Spain8.Hospital Universitario Lucus Augusti de Lugo,Lugo,Spain9.Service de Médecine Interne,Diabète et Maladies Métaboliques,H?pitaux Univer-sitaires de Strasbourg,France10.Servicio de Medicina Interna,IMIBIC/Hospital Universitario Reina Sofía,Córdoba,Spain
摘要：BACKGROUND Sacubitril-valsartan has been shown to reduce hospitalizations and mortality in patients with heart failure (HF) and reduced ejection fraction. The PIONEER-HF trial demonstrated that initiation of the drug during acute HF hospitaliza-tion reduced NT-proBNP levels and a post-hoc analysis of the trial found a reduction in HF hospitalizations and deaths. Real-life studies in the elderly population are scarce. The aim of our study was to assess the effectiveness of sacubitril-valsartan versusan-giotensin converting enzymeinhibitors (ACEI) in elderly patients who initiate this treatment during hospitalization for acute HF. METHODS We conducted a retrospective cohort study using the Spanish acute heart failure registry (RICA) comparing rehos-pitalizations and deaths at 3 months and 1 year among patients aged 70 years or older who had initiated treatment with sacubitril-valsartan during hospitalization for acute HF versus those treated with ACEI.RESULTS One hundred and ninety-nine patients hospitalized between October 2016 and November 2020 were included, with a median age of 82 years and high rate of comorbidity. Of these, 107 were treated with sacubitril-valsartan and 92 with ACEI. The adjusted OR for readmission for HF at 3 months was 0.906 (95％ CI: 0.241–3.404) and for the combined variable readmission for HF or death at 3 months was 0.696 (95％ CI: 0.224–2.167). The adjusted OR for HF readmission at one year was 0.696 (95％ CI:0.224 –2.167). and for the combined variable HF readmission or death at one year 0.724 (95％ CI: 0.325–1.612). CONCLUSION Treatment with sacubitril-valsartan initiated early in hospitalization for HF in elderly patients with high co-morbidity was associated with a trend towards a reduction in readmissions and death due to HF compared to treatment with ACEI, which did not reach statistical significance either at 3 months or 1 year of follow-up.
机标关键词：effectivenesssacubitrilinhibitorsregistryheartstudyacuteangiotensin
论文发表日期：2022-11-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 802-810 )