Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction

Bibliographic Details
Main Author: STRABURZYNSKA-MIGAJ, E. W.A.
Publication Date: 2023
Other Authors: 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.
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10362/158879
Summary: 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-2022). Publisher Copyright: © 2023 The Authors
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spelling Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal DysfunctionAn Analysis of the TRANSITION StudyAcute decompensated heart failureangiotensin receptor neprilysin inhibitorheart failure with reduced ejection fractionN-terminal-pro-B-type natriuretic peptiderenal dysfunctionsacubitril/valsartanCardiology and Cardiovascular MedicineFunding 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-2022). Publisher Copyright: © 2023 The AuthorsBackground: 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.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNSTRABURZYNSKA-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.2023-10-12T22:20:51Z2024-042024-04-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/158879eng1071-9164PURE: 73742529https://doi.org/10.1016/j.cardfail.2023.08.021info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2024-05-22T18:15:01Zoai:run.unl.pt:10362/158879Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T17:45:30.460627Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction
An Analysis of the TRANSITION Study
title Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction
spellingShingle Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction
STRABURZYNSKA-MIGAJ, E. W.A.
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
title_short Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction
title_full Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction
title_fullStr Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction
title_full_unstemmed Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction
title_sort Early Initiation of Sacubitril/Valsartan in Patients With Acute Heart Failure and Renal Dysfunction
author STRABURZYNSKA-MIGAJ, E. W.A.
author_facet 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.
author_role author
author2 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.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv 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.
dc.subject.por.fl_str_mv 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
topic 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
description 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-2022). Publisher Copyright: © 2023 The Authors
publishDate 2023
dc.date.none.fl_str_mv 2023-10-12T22:20:51Z
2024-04
2024-04-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/158879
url http://hdl.handle.net/10362/158879
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1071-9164
PURE: 73742529
https://doi.org/10.1016/j.cardfail.2023.08.021
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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