Clinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy

Background: The angiotensin receptor-neprilysin inhibitor (ARNI) decreases cardiovascular mortality in patients with chronic heart failure with a reduced ejection fraction (HFrEF). Data regarding the impact of ARNI on the outcome in HFrEF patients according to heart failure etiology are limited. Met...

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Autores principales:	Mohammad Abumayyaleh, Christina Pilsinger, Ibrahim El-Battrawy, Marvin Kummer, Jürgen Kuschyk, Martin Borggrefe, Andreas Mügge, Assem Aweimer, Ibrahim Akin
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	ARNI ICMP NICMP sacubitril/valsartan tachyarrhythmias outcomes Medicine R
Acceso en línea:	https://doaj.org/article/8826516588934d4a9a6bdd8986ee1be1
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spelling	oai:doaj.org-article:8826516588934d4a9a6bdd8986ee1be12021-11-11T17:37:14ZClinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy10.3390/jcm102149892077-0383https://doaj.org/article/8826516588934d4a9a6bdd8986ee1be12021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4989https://doaj.org/toc/2077-0383Background: The angiotensin receptor-neprilysin inhibitor (ARNI) decreases cardiovascular mortality in patients with chronic heart failure with a reduced ejection fraction (HFrEF). Data regarding the impact of ARNI on the outcome in HFrEF patients according to heart failure etiology are limited. Methods and results: One hundred twenty-one consecutive patients with HFrEF from the years 2016 to 2017 were included at the Medical Centre Mannheim Heidelberg University and treated with ARNI according to the current guidelines. Left ventricular ejection fraction (LVEF) was numerically improved during the treatment with ARNI in both patient groups, that with ischemic cardiomyopathy (<i>n</i> = 61) (ICMP), and that with non-ischemic cardiomyopathy (<i>n</i> = 60) (NICMP); <i>p</i> = 0.25. Consistent with this data, the NT-proBNP decreased in both groups, more commonly in the NICMP patient group. In addition, the glomerular filtration rate (GFR) and creatinine changed before and after the treatment with ARNI in both groups. In a one-year follow-up, the rate of ventricular tachyarrhythmias (ventricular tachycardia and ventricular fibrillation) tended to be higher in the ICMP group compared with the NICMP group (ICMP 38.71% vs. NICMP 17.24%; <i>p</i> = 0.07). The rate of one-year all-cause mortality was similar in both groups (ICMP 6.5% vs. NICMP 6.6%; log-rank = 0.9947). Conclusions: This study shows that, although the treatment with ARNI improves the LVEF in ICMP and NICMP patients, the risk of ventricular tachyarrhythmias remains higher in ICMP patients in comparison with NICMP patients. Renal function is improved in the NICMP group after the treatment. Long-term mortality is similar over a one-year follow-up.Mohammad AbumayyalehChristina PilsingerIbrahim El-BattrawyMarvin KummerJürgen KuschykMartin BorggrefeAndreas MüggeAssem AweimerIbrahim AkinMDPI AGarticleARNIICMPNICMPsacubitril/valsartantachyarrhythmiasoutcomesMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4989, p 4989 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ARNI ICMP NICMP sacubitril/valsartan tachyarrhythmias outcomes Medicine R
spellingShingle	ARNI ICMP NICMP sacubitril/valsartan tachyarrhythmias outcomes Medicine R Mohammad Abumayyaleh Christina Pilsinger Ibrahim El-Battrawy Marvin Kummer Jürgen Kuschyk Martin Borggrefe Andreas Mügge Assem Aweimer Ibrahim Akin Clinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy
description	Background: The angiotensin receptor-neprilysin inhibitor (ARNI) decreases cardiovascular mortality in patients with chronic heart failure with a reduced ejection fraction (HFrEF). Data regarding the impact of ARNI on the outcome in HFrEF patients according to heart failure etiology are limited. Methods and results: One hundred twenty-one consecutive patients with HFrEF from the years 2016 to 2017 were included at the Medical Centre Mannheim Heidelberg University and treated with ARNI according to the current guidelines. Left ventricular ejection fraction (LVEF) was numerically improved during the treatment with ARNI in both patient groups, that with ischemic cardiomyopathy (<i>n</i> = 61) (ICMP), and that with non-ischemic cardiomyopathy (<i>n</i> = 60) (NICMP); <i>p</i> = 0.25. Consistent with this data, the NT-proBNP decreased in both groups, more commonly in the NICMP patient group. In addition, the glomerular filtration rate (GFR) and creatinine changed before and after the treatment with ARNI in both groups. In a one-year follow-up, the rate of ventricular tachyarrhythmias (ventricular tachycardia and ventricular fibrillation) tended to be higher in the ICMP group compared with the NICMP group (ICMP 38.71% vs. NICMP 17.24%; <i>p</i> = 0.07). The rate of one-year all-cause mortality was similar in both groups (ICMP 6.5% vs. NICMP 6.6%; log-rank = 0.9947). Conclusions: This study shows that, although the treatment with ARNI improves the LVEF in ICMP and NICMP patients, the risk of ventricular tachyarrhythmias remains higher in ICMP patients in comparison with NICMP patients. Renal function is improved in the NICMP group after the treatment. Long-term mortality is similar over a one-year follow-up.
format	article
author	Mohammad Abumayyaleh Christina Pilsinger Ibrahim El-Battrawy Marvin Kummer Jürgen Kuschyk Martin Borggrefe Andreas Mügge Assem Aweimer Ibrahim Akin
author_facet	Mohammad Abumayyaleh Christina Pilsinger Ibrahim El-Battrawy Marvin Kummer Jürgen Kuschyk Martin Borggrefe Andreas Mügge Assem Aweimer Ibrahim Akin
author_sort	Mohammad Abumayyaleh
title	Clinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy
title_short	Clinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy
title_full	Clinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy
title_fullStr	Clinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy
title_full_unstemmed	Clinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy
title_sort	clinical outcomes in patients with ischemic versus non-ischemic cardiomyopathy after angiotensin-neprilysin inhibition therapy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8826516588934d4a9a6bdd8986ee1be1
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Clinical Outcomes in Patients with Ischemic versus Non-Ischemic Cardiomyopathy after Angiotensin-Neprilysin Inhibition Therapy

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