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Pearl Toh, 26 Sep 2019
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Sacubitril/valsartan effective in HFrEF patients with concurrent renal impairment, hypotension

14 Aug 2019

In heart failure patients with reduced ejection fraction (HFrEF) and renal impairment or hypotension, sacubitril/valsartan has been shown to be an effective angiotensin receptor and neprilysin inhibition (ARNI) intervention, reports a recent study.

The investigators included adult HFrEF patients undergoing standard HF treatment with (group A; n=466; mean age, 61.3±14.5 years; 75.3 percent male) and without (group B; n=466; mean age, 62.2±15.3 years; 73.4 percent male) sacubitril/valsartan. Primary outcomes included death from cardiovascular causes or a first unpanned HF hospitalization.

The primary outcomes occurred in 100 patients in group A, resulting in an incidence rate of 21.5 percent. This was significantly lower than that in group B (n=144; 30.9 percent; hazard ratio [HR], 0.66, 95 percent CI, 0.51–0.85; p=0.001).

Further disaggregation revealed that 31 (6.7 percent) of the incident cases in group A were deaths due to cardiovascular causes. The corresponding figure in group B was 59 (12.7 percent), which similarly resulted in a statistically significant difference in risk (HR, 0.50, 0.33–0.78; p=0.002). Deaths from all causes were likewise more common in group B (16.7 percent vs 9.2 percent; HR, 0.53, 0.36–0.77; p=0.001).

In group A, 87 patients (18.7 percent) had to be hospitalized for HF, as opposed to 132 (28.3 percent) in group B (HR, 0.62, 0.48–0.82; p<0.001), due to the consistent effect of the ARNI treatment in preventing first HF hospitalization or rehospitalization.

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Most Read Articles
Pearl Toh, 26 Sep 2019
The Singapore Health Sciences Authority (HSA) has recalled eight brands of ranitidine products containing trace amounts of the nitrosamine impurity NDMA*, which is a potential human carcinogen.
5 days ago
The use of folic acid in addition to enalapril in the treatment of patients with hypertension yields a modest increase in lifetime stroke-free survival, a study has found.
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Quadrivalent influenza vaccine (split virion, inactivated) 0.5 mL inj
Jairia Dela Cruz, 18 Jul 2018
Use of proton pump inhibitors and histamine‐2 receptor antagonists appears to reduce the risk of developing oesophageal carcinoma in patients with Barret’s oesophagus, according to a study.