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dc.contributor.authorPascual-Figal, Domingo A 
dc.contributor.authorWachter, Rolf
dc.contributor.authorSenni, Michele
dc.contributor.authorBao, Weibin
dc.contributor.authorNoè, Adele
dc.contributor.authorSchwende, Heike
dc.contributor.authorButylin, Dmytro
dc.contributor.authorPrescott, Margaret F
dc.date.accessioned2021-01-08T14:33:30Z
dc.date.available2021-01-08T14:33:30Z
dc.date.issued2020-10
dc.identifier.citationJACC Heart Fail. 2020; 8(10):822-833es_ES
dc.identifier.issn2213-1779
dc.identifier.urihttp://hdl.handle.net/20.500.12105/11590
dc.description.abstractThis study examined the effects of sacubitril/valsartan on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and determined patient characteristics associated with favorable NT-proBNP reduction response. NT-proBNP levels reflect cardiac wall stress and predict event risk in patients with acute decompensated heart failure (ADHF). Post-hoc analysis of the TRANSITION (Comparison of Pre- and Post-discharge Initiation of Sacubitril/Valsartan Therapy in HFrEF Patients After an Acute Decompensation Event) study, including stabilized ADHF patients with reduced ejection fraction, randomized to open-label sacubitril/valsartan initiation in-hospital (pre-discharge) versus post-discharge. NT-proBNP was measured at randomization (baseline), discharge, and 4 and 10 weeks post-randomization. A favorable NT-proBNP response was defined as reduction to ≤1,000 pg/ml or >30% from baseline. In patients receiving sacubitril/valsartan in-hospital, NT-proBNP was reduced by 28% at discharge, with 46% of patients obtaining favorable NT-proBNP reduction response compared with a 4% reduction and 18% favorable response rate in patients initiated post-discharge (p < 0.001). NT-proBNP was reduced similarly in patients initiating sacubitril/valsartan pre- and post-discharge (reduction at 4 weeks: 25%/22%; 10 weeks: 38%/34%) with comparable favorable response rates (46%/42% and 51%/48% at 4 and 10 weeks, respectively). NT-proBNP favorable response at 4 weeks was associated with lower risk of first heart failure (HF) rehospitalization or cardiovascular death through 26 weeks (hazard ratio: 0.57; 95% confidence interval [CI]: 0.38 to 0.86; p = 0.007). Predictors of a favorable response at 4 weeks were starting dose ≥49/51 mg twice daily, higher baseline NT-proBNP, lower baseline serum creatinine, de novo HF, no atrial fibrillation, angiotensin-converting enzyme inhibitor-naive or angiotensin receptor blocker-naive, and no prior myocardial infarction. In-hospital initiation of sacubitril/valsartan produced rapid reductions in NT-proBNP, statistically significant at discharge. A favorable NT-proBNP response over time was associated with a better prognosis and predicted by higher starting dose and predisposing clinical profile. (Comparison of Pre- and Post-discharge Initiation of LCZ696 Therapy in HFrEF Patients After an Acute Decompensation Event [TRANSITION]; NCT02661217).es_ES
dc.description.sponsorshipThe study was funded by Novartis Pharma AG, Basel, Switzerland. Dr. Pascual-Figal has served on the advisory board for and/or received speaker honoraria from Novartis, Servier, Roche, AstraZeneca, Vifor, Pfizer, and Abbott. Dr. Wachter has served on the advisory board for and/or received speakers honoraria from Boehringer Ingelheim, Bayer, CVRx, Medtronic, Novartis, Pfizer, Sanofi, and Servier; and received research grant supports from Boehringer Ingelheim, the European Union, and Bundesministerium für Bildung und Forschung. Dr. Senni has received consultancy fees and/or speaker honoraria from Novartis, Bayer, Abbott, Merck, AstraZeneca, Vifor Pharma, and Boehringer Ingelheim. Drs. Bao, Noè, Schwende, Butylin, and Prescott are employees of Novartis.es_ES
dc.language.isoenges_ES
dc.publisherElsevier es_ES
dc.type.hasVersionVoRes_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/*
dc.titleNT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction: TRANSITION Study.es_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución-NoComercial-CompartirIgual 4.0 Internacional*
dc.identifier.pubmedID32800508es_ES
dc.format.volume8es_ES
dc.format.number10es_ES
dc.format.page822-833es_ES
dc.identifier.doi10.1016/j.jchf.2020.05.012es_ES
dc.contributor.funderNovartis 
dc.contributor.funderBoehringer Ingelheim Fonds 
dc.contributor.funderUnión Europea 
dc.contributor.funderFederal Ministry of Education & Research (Alemania) 
dc.description.peerreviewedes_ES
dc.relation.publisherversionhttps://doi.org/10.1016/j.jchf.2020.05.012es_ES
dc.identifier.journalJACC. Heart failurees_ES
dc.repisalud.orgCNICCNIC::Grupos de investigación::Laboratorio Traslacional para la Imagen y Terapia Cardiovasculares_ES
dc.repisalud.institucionCNICes_ES
dc.rights.accessRightsopen accesses_ES


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Atribución-NoComercial-CompartirIgual 4.0 Internacional
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