Russo, Vincenzo, Ammendola, Ernesto, Gasperetti, Alessio, Bottino, Roberta, Schiavone, Marco, Masarone, Daniele, Pacileo, Giuseppe, Nigro, Gerardo, Golino, Paolo, Lip, Gregory YH et al (show 3 more authors)
(2022)
Add-on Therapy With Sacubitril/Valsartan and Clinical Outcomes in CRT-D Nonresponder Patients.
JOURNAL OF CARDIOVASCULAR PHARMACOLOGY, 79 (4).
pp. 472-478.
Abstract
<h4>Abstract</h4>No data on the add-on sacubitril/valsartan (S/V) therapy among cardiac resynchronization therapy with a defibrillator (CRT-D) nonresponder patients are currently available in literature. We conducted a prospective observational study including 190 CRT-D nonresponder patients with symptomatic heart failure with reduced ejection fraction despite the optimal medical therapy from at least 1 year. The primary endpoint was the rate of additional responders (left ventricular end-systolic volume reduction >15%) at 12 months from the introduction of S/V therapy. At the end of the 12 months follow-up, 37 patients (19.5%) were deemed as "additional responders" to the combination use of CRT + S/V therapy. The only clinical predictor of additional response was a lower left ventricular ejection fraction [OR 0.881 (0.815-0.953), P = 0.002] at baseline. At 12 months follow-up, there were significant improvements in heart failure (HF) symptoms and functional status [New York Heart Association 2 (2-3) vs. 1 (1-2), P < 0.001; physical activity duration/day: 10 (8-12) vs. 13 (10-18) hours, P < 0.001]. Compared with the 12 months preceding S/V introduction, there were significant reductions in the rate of HF rehospitalization (35.5% vs. 19.5%, P < 0.001), in atrial tachycardia/atrial fibrillation burden [6.0 (5.0-8.0) % vs. 0 (0-2.0) %, P < 0.001] and in the proportions of patients experiencing ventricular arrhythmias (21.6% vs. 6.3%; P < 0.001). Our results indicate that S/V add-on therapy in CRT-D nonresponder patients is associated with 19.5% of additional responders, a reduction in HF symptoms and rehospitalizations, AF burden, and ventricular arrhythmias.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | sacubitril, valsartan, cardiac resynchronization therapy, heart failure, ventricular remodeling, arrhythmias |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 05 May 2022 15:16 |
| Last Modified: | 18 Jan 2023 21:04 |
| DOI: | 10.1097/FJC.0000000000001202 |
| Open Access URL: | https://journals.lww.com/cardiovascularpharm/Fullt... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3154337 |
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