Al Raddadi Sultan, Almutairi Majed, AlAamer Kholoud, Alsalman Abdulmahsen, Albalawi Maram, Almeshary Meshary, Badreldin Hisham A, Almodaimegh Hind
Department of Pharmaceutical Care, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia.
Department of Pharmacy Practice, College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Drug Healthc Patient Saf. 2024 Sep 30;16:117-124. doi: 10.2147/DHPS.S471867. eCollection 2024.
Sacubitril/valsartan (S/V) is used in managing heart failure with reduced ejection fraction (HFrEF), reducing morbidity and mortality while improving symptoms and prognosis. This study aims to evaluate the effectiveness of S/V in patients with reduced left ventricular ejection fraction (LVEF) and its safety.
This retrospective cohort study included adult patients aged ≥18 years diagnosed with HFrEF, receiving S/V, and followed up at a tertiary hospital in Riyadh. Primary outcomes included improvements in LVEF on echocardiography and the number of hospitalizations due to acute decompensated heart failure (ADHF). Secondary outcomes assessed the safety profile of S/V. Multinomial logistic regression analysis was performed with statistical significance set at P < 0.05. .
The study included 107 patients: 80 with LVEF < 30% and 27 with LVEF 30-40%. Six-month follow-up, LVEF improvement was categorized into three groups: no improvement, LVEF increased by 1 to <10 points, and LVEF increased by ≥10 points. The LVEF was similar across groups (P = 0.59). Although hospitalizations due to ADHF were not significantly different between groups, they numerically decreased after initiating S/V (P = 0.1). S/V was generally well tolerated.
This study suggests no significant benefit from S/V regarding LVEF improvement. It is recommended that heart failure clinics assess and titrate S/V to the maximum tolerated dose.
沙库巴曲缬沙坦（S/V）用于治疗射血分数降低的心力衰竭（HFrEF），可降低发病率和死亡率，同时改善症状和预后。本研究旨在评估S/V对左心室射血分数（LVEF）降低患者的有效性及其安全性。
这项回顾性队列研究纳入了年龄≥18岁、被诊断为HFrEF、接受S/V治疗并在利雅得一家三级医院接受随访的成年患者。主要结局包括超声心动图检查显示的LVEF改善情况以及因急性失代偿性心力衰竭（ADHF）住院的次数。次要结局评估了S/V的安全性。进行多项逻辑回归分析，设定统计学显著性为P<0.05。
该研究纳入了107例患者：80例LVEF<30%，27例LVEF为30 - 40%。在6个月的随访中，LVEF改善情况分为三组：无改善、LVEF增加1至<10个百分点、LVEF增加≥10个百分点。各组之间的LVEF相似（P = 0.59）。虽然因ADHF住院的情况在各组之间无显著差异，但在开始使用S/V后，住院次数在数值上有所下降（P = 0.1）。S/V总体耐受性良好。
本研究表明，S/V在改善LVEF方面无显著益处。建议心力衰竭诊所评估并将S/V滴定至最大耐受剂量。
