التفاصيل البيبلوغرافية
| العنوان: |
Effect of sacubitril/valsartan on cardiac remodeling compared with other renin–angiotensin system inhibitors: a difference-in-difference analysis of propensity-score matched samples. |
| المؤلفون: |
Carluccio, Erberto, Dini, Frank L., Correale, Michele, Dattilo, Giuseppe, Ciccarelli, Michele, Vannuccini, Francesca, Sforna, Stefano, Pacileo, Giuseppe, Masarone, Daniele, Scelsi, Laura, Ghio, Stefano, Tocchetti, Carlo Gabriele, Mercurio, Valentina, Brunetti, Natale Daniele, Nodari, Savina, Ambrosio, Giuseppe, Palazzuoli, Alberto |
| المصدر: |
Clinical Research in Cardiology; Jun2024, Vol. 113 Issue 6, p856-865, 10p |
| مستخلص: |
Background: In patients with heart failure with reduced ejection fraction (HFrEF), treatment with sacubitril–valsartan (S/V) may reverse left ventricular remodeling (rLVR). Whether this effect is superior to that induced by other renin–angiotensin system (RAS) inhibitors is not well known. Methods: HFrEF patients treated with S/V (n = 795) were compared, by propensity score matching, with a historical cohort of 831 HFrEF patients (non-S/V group) treated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (RAS inhibitors). All patients were also treated with beta-blockers and shared the same protocol with repeat echocardiogram 8–12 months after starting therapy. The difference-in-difference (DiD) analysis was used to evaluate the impact of S/V on CR indices between the two groups. Results: After propensity score matching, compared to non-S/V group (n = 354), S/V group (n = 354) showed a relative greater reduction in end-diastolic and end-systolic volume index (ESVI), and greater increase in ejection fraction (DiD estimator = + 5.42 mL/m2, P = 0.0005; + 4.68 mL/m2, P = 0.0009, and + 1.76%, P = 0.002, respectively). Reverse LVR (reduction in ESVI ≥ 15% from baseline) was more prevalent in S/V than in non-S/V group (34% vs 26%, P = 0.017), while adverse LVR (aLVR, increase in ESVI at follow-up ≥ 15%) was more frequent in non-S/V than in S/V (16% vs 7%, P < 0.001). The beneficial effect of S/V on CR over other RAS inhibitors was appreciable across a wide range of patient's age and baseline end-diastolic volume index, but it tended to attenuate in more dilated left ventricles (P for interaction = NS for both). Conclusion: In HFrEF patients treated with beta-blockers, sacubitril/valsartan is associated with a relative greater benefit in LV reverse remodeling indices than other RAS inhibitors. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
