Huitema Ashlay A, Daoust Alexia, Anderson Kim, Poon Stephanie, Virani Sean, White Michel, Rojas-Fernandez Carlos, Zieroth Shelley, McKelvie Robert S
St Joseph's Health Care London, London, Ontario, Canada.
Western University, London, Ontario, Canada.
CJC Open. 2020 Apr 5;2(5):321-327. doi: 10.1016/j.cjco.2020.03.015. eCollection 2020 Sep.
Heart failure (HF) with reduced ejection fraction represents approximately 50% of the 600,000 Canadians currently living with HF and over 90,000 new cases diagnosed each year. The angiotensin receptor neprilysin inhibitor, sacubitril/valsartan, demonstrated superior efficacy in reducing cardiovascular death and HF hospitalization over standard of care therapy.
The potential magnitude of benefit in Canada with respect to preventing or postponing deaths and reducing hospitalizations resulting from its optimal implementation in patients with HF with an ejection fraction <40% was estimated based on published sources.
Of the potentially eligible 225,562 patients, this would amount to the prevention of 4699 cardiovascular deaths and first HF hospitalizations, 3698 thirty-day HF readmissions, and 2820 deaths due to all-cause mortality. The number of patients receiving sacubitril/valsartan nationally in 2018 was 27,267. This represents approximately 12% of the calculated eligible population for this therapy in Canada.
The findings from this analysis suggest that a substantial number of deaths, hospitalizations, and HF readmissions could potentially be avoided by optimal usage of sacubitril/valsartan therapy in Canada. This emphasizes the importance of rapidly and appropriately implementing evidence-based medications into routine clinical practice, to achieve the best possible outcomes for our patients with HF and to reduce the high burden and cost of HF in Canada.
射血分数降低的心力衰竭（HF）约占目前加拿大60万HF患者的50%，且每年有超过90,000例新病例被诊断出来。血管紧张素受体脑啡肽酶抑制剂沙库巴曲缬沙坦在降低心血管死亡和HF住院方面显示出优于标准治疗的疗效。
根据已发表的资料，估计了在加拿大，对于射血分数<40%的HF患者，通过最佳实施该药物预防或推迟死亡以及减少住院的潜在获益程度。
在225,562名潜在符合条件的患者中，这将意味着预防4699例心血管死亡和首次HF住院、3698例30天HF再入院以及2820例全因死亡。2018年在加拿大全国接受沙库巴曲缬沙坦治疗的患者人数为27,267人。这约占加拿大该治疗方法计算出的符合条件人群的12%。
该分析结果表明，在加拿大，通过最佳使用沙库巴曲缬沙坦治疗，可能避免大量死亡、住院和HF再入院情况。这强调了迅速且适当地将循证药物应用于常规临床实践的重要性，以便为我们的HF患者实现最佳治疗效果，并降低加拿大HF的高负担和高成本。
