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Sacubitril/valsartan eligibility and outcomes in the ESC-EORP-HFA Heart Failure Long-Term Registry [Elektronski vir] : bridging between European Medicines Agency/Food and Drug Administration label, the PARADIGM-HF trial, ESC guidelines, and real worldKapelios, Chris J. ...AIMS: To assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF) who are eligible for sacubitril/valsartan (LCZ696) based on the European Medicines Agency/Food and ... Drug Administration (EMA/FDA) label, the PARADIGM-HF trial and the 2016 ESC guidelines, and the association between eligibility and outcomes. METHODS AND RESULTS: Outpatients with HFrEF in the ESC-EORP-HFA Long-Term Heart Failure (HF-LT) Registry between March 2011 and November 2013 were considered. Criteria for LCZ696 based on EMA/FDA label, PARADIGM-HF and ESC guidelines were applied. Of 5443 patients, 2197 and 2373 had complete information for trial and guideline eligibility assessment, and 84%, 12% and 12% met EMA/FDA label, PARADIGM-HF and guideline criteria, respectively. Absent PARADIGM-HF criteria were low natriuretic peptides (21%), hyperkalemia (4%), hypotension (7%) and sub-optimal pharmacotherapy (74%); absent Guidelines criteria were LVEF>35% (23%), insufficient NP levels (30%) and sub-optimal pharmacotherapy (82%); absent label criteria were absence of symptoms (New York Heart Association class I). When a daily requirement of ACEi/ARB >10 mg enalapril (instead of >20 mg) was used, eligibility rose from 12% to 28% based on both PARADIGM-HF and guidelines. One-year heart failure hospitalization was higher (12% and 17% vs. 12%) and all-cause mortality lower (5.3% and 6.5% vs. 7.7%) in registry eligible patients compared to the enalapril arm of PARADIGM-HF. CONCLUSIONS: Among outpatients with HFrEF in the ESC-EORP-HFA HF-LT Registry, 84% met label criteria, while only 12% and 28% met PARADIGM-HF and guideline criteria for LCZ696 if requiring >20 mg and >10 mg enalapril, respectively. Registry patients eligible for LCZ696 had greater heart failure hospitalization but lower mortality rates than the PARADIGM-HF enalapril group.Source: European Journal of Heart Failure [Elektronski vir]. - ISSN 1879-0844 (Vol. 21, iss. 11, 2019, Str. 1383-1397)Type of material - e-articlePublish date - 2019Language - englishCOBISS.SI-ID - 512918584
Author
Kapelios, Chris J. |
Lainščak, Mitja |
Savarese, Gianluigi |
Laroche, Cécile |
Seferović, Petar M., 1951- |
Ruschitzka, Frank |
Coats, Andrew J. |
Anker, Stefan D. |
Crespo-Leiro, Maria G. |
Filippatos, Gerasimos
Other authors
Strašek, Milena |
Savnik-Iskra, Mojca |
Ravnikar, Tinkara |
Černič Šuligoj, Nataša, 1956- |
Komel, Jana |
Fras, Zlatko |
Jug, Borut, 1975- |
Glavič, Tanja |
Lošić, Renata |
Bombek, Mirko |
Krajnc, Igor, 1969- |
Krunič, Barbara |
Horvat, S., medicina |
Kovac, Dusan, medicina |
Rajtman, Darko |
Cenčič, Vid |
Letonja, Mitja |
Winkler, Robert |
Valentinčič, Matej |
Melihen Bartolič, Cvetka |
Bartolić, Andrej |
Pušnik, Maja |
Kladnik, Majda |
Slemenik-Pušnik, Cirila |
Marolt, Apolon |
Klen, Jasna |
Drnovšek, Borut, zdravnik |
Leskovar, Boštjan, medicina, 1970-
Topics
angiotensin receptor-neprilysin inhibitor |
eligibility |
prognosis |
LCZ696 |
registry |
Sacubitril/valsartan
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