scholarly journals Angiotensin Receptor Neprilysin Inhibitor in Japanese Patients With Heart Failure and Reduced Ejection Fraction　― Baseline Characteristics and Treatment of PARALLEL-HF Trial ―

2018 ◽  
Vol 82 (10) ◽  
pp. 2575-2583 ◽  
Author(s):  
Hiroyuki Tsutsui ◽  
Shin-ichi Momomura ◽  
Yoshihiko Saito ◽  
Hiroshi Ito ◽  
Kazuhiro Yamamoto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Japanese Patients ◽  
Angiotensin Receptor ◽  
Reduced Ejection Fraction ◽  
Neprilysin Inhibitor ◽  
Patients With Heart Failure ◽  
Angiotensin Receptor Neprilysin Inhibitor ◽  
Baseline Characteristics

scholarly journals Effect of Angiotensin Receptor-Neprilysin Inhibitor and Sodium-Glucose Co-transporter-2 Inhibitor Combination Therapy in Diabetic Patients with Heart Failure with Reduced Ejection Fraction: A Retrospective Study

2021 ◽  
Author(s):  
Hyue Mee Kim ◽  
In-Chang Hwang ◽  
Wonsuk Choi ◽  
Yeonyee E. Yoon ◽  
Goo-Yeong Cho
Keyword(s):  
Heart Failure ◽  
Combination Therapy ◽  
Ejection Fraction ◽  
Diabetic Patients ◽  
Angiotensin Receptor ◽  
Reduced Ejection Fraction ◽  
Neprilysin Inhibitor ◽  
Patients With Heart Failure ◽  
Angiotensin Receptor Neprilysin Inhibitor ◽  
Group 1

Abstract Background Angiotensin receptor-neprilysin inhibitor (ARNI) and sodium-glucose co-transporter-2 inhibitor (SGLT2i) have shown robust benefits in improving cardiac function and disease prognosis in diabetic patients with heart failure with reduced ejection fraction (HFrEF). However, their combined effect has not been revealed. Methods We retrospectively identified diabetic patients with HFrEF who were prescribed an ARNI and/or SGLT2i. Diabetic patients with HFrEF treated with standard HF therapy but not ARNI or SGLT2i were included as controls. The patients were divided into groups treated with both ARNI and SGLT2i (group 1), ARNI but not SGLT2i (group 2), SGLT2i but not ARNI (group 3), and neither ARNI nor SGLT2i (group 4). After propensity score-matching, the occurrence of hospitalization for heart failure (HHF), cardiovascular mortality, and changes in echocardiographic parameters were analyzed. Results Of the 206 matched patients included in the study, 90 (43.7%) had to undergo HHF and 43 (20.9%) died of cardiovascular causes during a median 25 months of follow-up. Patients in group 1 exhibited a lower risk of HHF and cardiovascular mortality compared to those in the other groups. Improvements in the left ventricular ejection fraction and mitral E/e’ were more pronounced in group 1 than in groups 2, 3 and 4. These echocardiographic improvements were more prominent after the initiation of ARNI, compare to the initiation of SGLT2i. Conclusion In diabetic patients with HFrEF, combination of ARNI and SGT2i showed significant improvement in cardiac function and prognosis. ARNI-SGLT2i combination therapy may improve the clinical course of HFrEF in diabetic patients.

Abstract 17955: Reduction in 30-day Rehospitalization After Discharge From a Heart Failure Admission in Patients Receiving LCZ696 versus Enalapril: PARADIGM-HF

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Scott D Solomon ◽  
Milton Packer ◽  
Michael Zile ◽  
Jean Rouleau ◽  
Karl Swedberg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiovascular Death ◽  
Heart Failure Hospitalization ◽  
Reduced Ejection Fraction ◽  
Neprilysin Inhibitor ◽  
Patients With Heart Failure ◽  
Angiotensin Receptor Neprilysin Inhibitor ◽  
Heart Failure Admission ◽  
Baseline Characteristics

Introduction: The angiotensin receptor neprilysin inhibitor LCZ696 reduced cardiovascular death, heart failure hospitalization and all-cause mortality in patients with heart failure and reduced ejection fraction compared with enalapril. Hypothesis: We hypothesized that LCZ696 would reduce 30-day readmission after a heart failure hospitalization. Methods: PARADIGM-HF randomized 8399 patients with HF and reduced ejection fraction to either LCZ696 200mg bid or Enalapril 10mg bid. We assessed the risk of 30-day readmission for any cause following investigator reported and adjudicated hospitalization for heart failure. Admission and discharge dates were available for 2800 hospitalizations (95%) in 1638 patients. Results: Of 2800 HF hospitalizations, 1545 occurred in 871 patients in the enalapril group and 1255 occurred in 767 patients in the LCZ arm. Overall, 10.5% of these HF hospitalizations were followed by a repeat hospitalization for any cause within 30 days of discharge, and this occurred significantly less frequently in the LCZ arm (8.7%) relative to the enalapril arm (12.0%), in both unadjusted models and a random-effects logistic regression model accounting for the repeated HF hospitalizations experienced by some patients. We observed similar results in a sensitivity analysis restricted only to the first HF hospitalization for each patient. Further adjustment for baseline characteristics did not alter these findings. Similar effect sizes were observed for adjudicated heart failure hospitalizations. Conclusion: In patients admitted with heart failure in PARADIGM-HF, LCZ reduced 30-day readmissions for any-cause.

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