Comparative effectiveness analysis of data from the Optum Electronic Health Record dataset shows sacubitril/valsartan (Entresto ) provides insight into the benefits of Ejection fraction (HFmrEF/HFpEF) is mildly reduced or maintained.

“What we know from the way the FDA has labeled this in recent guidelines is that this treatment is more effective than ACEs and ARBs, especially in patients with: [ejection fraction] “Below normal.” Where I think there is a reasonable data gap is with patients who are newly diagnosed with heart failure,” said study investigator, Kaiser Permanente Northern California Research Scientist and Kaiser San Francisco Medical Center Associate Physician. explained Ankeet Bhatt, MD, MBA. “Thus, this gives us some confidence that the benefits observed in most clinical trial populations can indeed potentially be extended to patients with de novo heart failure who have mildly reduced or preserved ejection fraction. I think it will.”

This retrospective, propensity-matched cohort study, presented at the 2024 American College of Cardiology (ACC.24) Annual Scientific Sessions, utilized a database to evaluate the effects of the angiotensin receptor/neprilysin inhibitors sacubitril/valsartan. It was designed for the purpose of judgment. All-cause hospitalization rates compared to ACE inhibitors or ARBs for patients with: Also Heart failure and ejection fraction greater than 40%.

From the database, researchers identified 458 patients meeting these criteria receiving sacubitril/valsartan, who were in a 2:1 ratio with 916 patients receiving ACE inhibitors or ARBs. It was agreed. The mean age of this cohort was 65.5 (SD, 13.95) years, 62% were male, and 80% were Caucasian. Mean follow-up was 391 days in the sacubitril/valsartan group and 553 days in the ACE inhibitor or ARB cohort. The researchers noted that 65% and 57% of the cohort had hypertension and ischemic heart disease, respectively.

Analysis showed that the annual all-cause hospitalization rate was 0.79 per person-year in the sacubitril/valsartan group compared with 1.24 per person-year in the ACE inhibitor or ARB group ( incidence rate ratio) [IRR]0.73, 95% confidence interval [CI]0.59-0.92; P = .006). Further analysis showed that patients in the sacubitril/valsartan group had a hospitalization rate of 1.01 hospitalizations per person-year in the ACE inhibitor or ARB cohort compared to 0.65 hospitalizations per person-year in the sacubitril/valsartan cohort. (IRR, 0.70, 95%) CI, 0.55 to 0.88. P = .002).

For more insight into this research and how it impacts clinical decision-making, check out ACC.24’s interview with Bhatt.

Related disclosures for Bhatt: Sanofi-Aventis.

References:

Bhatt AS, Vaduganathan M, Jena BP et al. Comparison of the efficacy of sacubitril/valsartan and angiotensin-converting enzyme inhibitor/angiotensin receptor antagonist in patients with de novo heart failure with mildly reduced and preserved ejection fraction. Eur J Heart Fail. Published online on April 7, 2024. doi:10.1002/ejhf.3233