Sacubitril, Valsartan combo effective in high risk heart failure patients: Circulation

The composite of rehospitalization for HF or cardiovascular death was adjudicated. Safety outcomes included symptomatic hypotension, worsening renal function, and hyperkalemia.

The researchers evaluated heterogeneity in the effect of sacubitril/valsartan on these safety in selected subgroups of clinical concern -- patients with baseline systolic blood pressure ≤118 mm Hg (median; n=448), baseline NT-proBNP >2701 pg/mL (median; n=395), estimated glomerular filtration rate <60 mL/minute per 1.73 m2 (n=455), ≥1 additional hospitalization for HF within the prior year (n=343), admission to the ICU during the index hospitalization (n=96), inotrope use during the index hospitalization (n=68), and severe congestion (n=219). 

"In high-risk subpopulations admitted for acute decompensated HF, treatment with sacubitril/valsartan after initial stabilization conferred a consistent reduction in cardiovascular death or rehospitalization for HF and was well tolerated," concluded the authors. 

The study titled, "Efficacy and Safety of Sacubitril/Valsartan in High-Risk Patients in the PIONEER-HF Trial," is published in the journal Circulation: Heart Failure.

DOI: https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.120.007034