دورية أكاديمية
Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction ; An Analysis of the TRANSITION Study
| العنوان: | Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction ; An Analysis of the TRANSITION Study |
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| المؤلفون: | STRABURZYNSKA-MIGAJ, E. W.A., SENNI, M., WACHTER, R., FONSECA, C., WITTE, K. K., MUELLER, C., LONN, E., BUTYLIN, D., NOE, A., SCHWENDE, H., LAWRENCE, D., SURYAWANSHI, B., PASCUAL-FIGAL, D. |
| المساهمون: | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) |
| سنة النشر: | 2024 |
| المجموعة: | Repositório da Universidade Nova de Lisboa (UNL) |
| مصطلحات موضوعية: | Acute decompensated heart failure, angiotensin receptor neprilysin inhibitor, heart failure with reduced ejection fraction, N-terminal-pro-B-type natriuretic peptide, renal dysfunction, sacubitril/valsartan, Cardiology and Cardiovascular Medicine |
| الوصف: | Funding Information: This study was funded by Novartis . Funding Information: This study was funded by Novartis. The authors thank Tripti Sahu of Novartis Healthcare Pvt. Ltd. for providing medical writing support in accordance with Good Publication Practice (GPP 2022) guidelines (https://www.ismpp.org/gpp-2022Test). Publisher Copyright: © 2023 The Authors ; Background: Treatment of patients with heart failure with reduced ejection fraction (HFrEF) and renal dysfunction (RD) is challenging owing to the risk of further deterioration in renal function, especially after acute decompensated HF (ADHF). Methods and Results: We assessed the effect of RD (estimated glomerular filtration rate of ≥30 to <60 mL/min/1.73 m2) on initiation, up-titration, and tolerability of sacubitril/valsartan in hemodynamically stabilized patients with HFrEF admitted for ADHF (RD, n = 476; non-RD, n = 483). At week 10, the target dose of sacubitril/valsartan (97/103 mg twice daily) was achieved by 42% patients in RD subgroup vs 54% in non-RD patients (P < .001). Sacubitril/valsartan was associated with greater estimated glomerular filtration rate improvements in RD subgroup than non-RD (change from baseline least squares mean 4.1 mL/min/1.73 m2, 95% confidence interval 2.2–6.1, P < .001). Cardiac biomarkers improved significantly in both subgroups; however, compared with the RD subgroup, the improvement was greater in those without RD (N-terminal pro-brain natriuretic peptide, −28.6% vs −44.8%, high-sensitivity troponin T −20.3% vs −33.9%) (P < .001). Patients in the RD subgroup compared with those without RD experienced higher rates of hyperkalemia (16.3% vs 6.5%, P < .001), investigator-reported cardiac failure (9.7% vs 5.6%, P = .029), and renal impairment (6.4% vs 2.1%, P = .002). Conclusions: Most patients with HFrEF and concomitant RD hospitalized for ADHF tolerated early initiation of sacubitril/valsartan and showed significant improvements in estimated glomerular filtration rate and cardiac biomarkers. Clinical Trial ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1071-9164 |
| العلاقة: | PURE: 73742529; PURE UUID: 6e6ef821-fed4-44a0-89e5-5f3c157204db; Scopus: 85173153867; PubMed: 37678704; http://hdl.handle.net/10362/158879Test; https://doi.org/10.1016/j.cardfail.2023.08.021Test |
| DOI: | 10.1016/j.cardfail.2023.08.021 |
| الإتاحة: | https://doi.org/10.1016/j.cardfail.2023.08.021Test http://hdl.handle.net/10362/158879Test |
| حقوق: | openAccess |
| رقم الانضمام: | edsbas.61088A74 |
| قاعدة البيانات: | BASE |
| تدمد: | 10719164 |
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| DOI: | 10.1016/j.cardfail.2023.08.021 |