Klinikum Ludwigshafen, Medizinische Klinik B and Institut für Herzinfarktforschung, Bremserstrasse 79, 67063 Ludwigshafen-am-Rhein, Germany.
Castle Hill Hospital, Kingston Upon Hull, Castle Rd, Cottingham HU16 5JQ, United Kingdom.
Eur Heart J Qual Care Clin Outcomes. 2022 Jun 6;8(4):469-477. doi: 10.1093/ehjqcco/qcab019.
To compare baseline characteristics of patients with heart failure with reduced ejection fraction (HFrEF) initiated on sacubitril/valsartan compared with patients continued on conventional heart failure (HF)-treatment in a European out-patient setting.
Between July 2016 and July 2019, ARIADNE enrolled 8787 outpatients aged ≥18 years with HFrEF from 17 European countries. Choice of therapy was solely at the investigators' discretion. In total, 4173 patients were on conventional HF-treatment (non-S/V group), while 4614 patients were on sacubitril/valsartan either at enrolment or started sacubitril/valsartan within 1 month of enrolment (S/V group). Of these, 2108 patients started sacubitril/valsartan treatment ±1 month around enrolment [restricted S/V (rS/V) group]. The average age of the patients was 68 years. Patients on S/V were more likely to have New York Heart Association (NYHA) class III or IV symptoms (50.3%, 44.6%, 32.1% in rS/V, S/V, and non-S/V, respectively) and had lower left ventricular ejection fraction (LVEF; 32.3%, 32.7%, and 35.4% in rS/V, S/V, and non-S/V, respectively; P < 0.0001). The most frequently received HF treatments were angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB; ∼84% in non-S/V), followed by β-blockers (∼80%) and mineralocorticoid receptor antagonists (MRAs; 53%). The use of triple HF therapy (ACEI/ARB/angiotensin receptor neprilysin inhibitor with β-blockers and MRA) was higher in the S/V groups than non-S/V group (48.2%, 48.2%, and 40.2% in rS/V, S/V, and non-S/V, respectively).
In this large multinational HFrEF registry, patients receiving sacubitril/valsartan tended to be younger with lower LVEF and higher NYHA class. Fewer than half of the patients received triple HF therapy.
比较射血分数降低的心力衰竭（HFrEF）患者在欧洲门诊环境下开始使用沙库巴曲缬沙坦与继续接受传统心力衰竭（HF）治疗的患者的基线特征。
2016 年 7 月至 2019 年 7 月，ARIADNE 纳入了来自 17 个欧洲国家的≥18 岁射血分数降低的心力衰竭患者 8787 例。治疗选择完全由研究者决定。共有 4173 例患者接受传统 HF 治疗（非 S/V 组），而 4614 例患者在入组时或入组后 1 个月内开始接受沙库巴曲缬沙坦治疗（S/V 组）。其中，2108 例患者在入组前后 1 个月内开始沙库巴曲缬沙坦治疗[限制性 S/V（rS/V）组]。患者的平均年龄为 68 岁。S/V 组患者更有可能出现纽约心脏协会（NYHA）心功能分级 III 或 IV 级症状（rS/V、S/V 和非 S/V 组分别为 50.3%、44.6%和 32.1%），左心室射血分数（LVEF）更低（rS/V、S/V 和非 S/V 组分别为 32.3%、32.7%和 35.4%；P<0.0001）。最常接受的心力衰竭治疗是血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂（ACEI/ARB；非 S/V 组约 84%），其次是β受体阻滞剂（约 80%）和盐皮质激素受体拮抗剂（MRA；53%）。S/V 组三联心力衰竭治疗（ACEI/ARB/血管紧张素受体脑啡肽酶抑制剂联合β受体阻滞剂和 MRA）的使用率高于非 S/V 组（rS/V、S/V 和非 S/V 组分别为 48.2%、48.2%和 40.2%）。
在这项大型多国射血分数降低的心力衰竭登记研究中，接受沙库巴曲缬沙坦治疗的患者年龄较小，LVEF 较低，NYHA 心功能分级较高。不到一半的患者接受三联心力衰竭治疗。
