Por favor, use este identificador para citar o enlazar este Item:http://hdl.handle.net/20.500.12105/19248
Título
Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction: An Analysis of the TRANSITION Study.
Autor(es)
Straburzynska-Migaj, Ewa | 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, Domingo A CNIC
Fecha de publicación
2024-03
Cita
J Card Fail. 2024 Mar;30(3):425-435.
Idioma
Inglés
Tipo de documento
journal article
Resumen
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 REGISTRATION
NCT02661217.
MESH
Heart Failure | Kidney Diseases | Ventricular Dysfunction, Left | Humans | Aminobutyrates | Angiotensin Receptor Antagonists | Biomarkers | Biphenyl Compounds | Drug Combinations | Stroke Volume | Tetrazoles | Treatment Outcome | Valsartan
Versión en línea
DOI
Aparece en las colecciones
Ficheros en el ítem
- Nombre:
- Early Initiation of Sacubitril ...
- Tamaño:
- 781.0Kb
- Formato:
- Descripción:
- Artículo