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Myocardial work predicts MACE in HFrEF patients on sacubitril/valsartan

29 Dec 2020

Sacubitril/valsartan induces significant improvements in myocardial constructive work (CW) and myocardial work efficiency (WE) in patients with heart failure with reduced ejection fraction (HFrEF) who receive comprehensive background beta-blocker and mineral-corticoid receptor antagonist therapy. In these patients, CW is shown to predict major adverse cardiac events (MACEs).

Among 79 patients with HFrEF treated with sacubitril/valsartan who underwent echocardiography at baseline and after 6 months and 12 months of treatment, significant increases were seen in global myocardial CW and myocardial WE (p<0.0001 for both). [Galli E, et al, ESC 2020]

During 2.6 years of follow-up, CW was the only predictor of MACEs (hazard ratio [HR], 0.99; 95 percent confidence interval [CI], 0.99 to 1.00; p=0.04) after correction for left ventricular (LV) size, LVEF and WE. A myocardial CW of <910 mm Hg identified patients at particularly high risk of MACEs (HR, 11.09; 95 percent CI, 1.45 to 98.94; p=0.002).

“Estimation of CW before initiation of sacubitril/valsartan therapy allows the prediction of MACEs,” the investigators concluded.


 

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Most Read Articles
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Tristan Manalac, 5 days ago
New research has found that Gaucher disease may be more phenotypically diverse than previously thought, underscoring the need to revisit the existing disease classifications.
2 days ago
Among patients with moderate-to-severe psoriasis, the use of biologics appears to lower the risk of being hospitalized for the novel coronavirus disease (COVID-19), a new study has found.
10 Jan 2021
For older adults, dancing may improve global cognitive function, although it has little effect on complex attention, learning, and memory, according to a systematic review and meta-analysis.