Renal protective effect of sacubitril/valsartan in patients with heart failure

Abstract Sacubitril/valsartan is a combined neprilysin inhibitor/angiotensin II receptor blocker designed for treatment of heart failure (HF). Nonetheless, its renal protective effect remained an issue of debate. This retrospective cohort study investigated the renal protective effect of sacubitril/...

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Autores principales:	Hui-Ling Hsieh, Chun-You Chen, Cheng-Hsien Chen, Shih-Chang Hsu, Wen-Cheng Huang, Yuh-Mou Sue, Feng-Yen Lin, Chun-Ming Shih, Yue-Cune Chang, Po-Hsun Huang, Chung-Te Liu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/946ef0408dc44a6cae1072af72b69f17
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spelling	oai:doaj.org-article:946ef0408dc44a6cae1072af72b69f172021-12-02T11:37:19ZRenal protective effect of sacubitril/valsartan in patients with heart failure10.1038/s41598-021-84118-82045-2322https://doaj.org/article/946ef0408dc44a6cae1072af72b69f172021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84118-8https://doaj.org/toc/2045-2322Abstract Sacubitril/valsartan is a combined neprilysin inhibitor/angiotensin II receptor blocker designed for treatment of heart failure (HF). Nonetheless, its renal protective effect remained an issue of debate. This retrospective cohort study investigated the renal protective effect of sacubitril/valsartan in HF patients. HF patients on sacubitril/valsartan or valsartan for > 30 days were matched for gender, age, estimated glomerular filtration rate (eGFR), and left ventricular ejection fraction (LVEF) to be enrolled into analysis. The follow-up period was 18 months. The outcomes included end eGFR, renal function decline defined as 20% reduction of eGFR, mortality, and HF-related hospitalization. Each group had 137 patients after matching. The mean age was 72.7 years and 65.7% were male. Mean eGFR was 70.9 mL/min/1.73 m2 and LVEF was 54.0% at baseline. Overall, the eGFR of sacubitril/valsartan groups was significantly higher than valsartan group at the end (P < 0.01). Subgroup analysis showed that the difference in eGFR was significant in subgroups with LVEF ≥ 40% or eGFR ≥ 60 mL/min/1.73 m2. Multivariate Cox regression model showed that sacubitril/valsartan group had significantly reduced risk for renal function decline (hazard ratio: 0.5, 95% confidence interval: 0.3–0.9). Kaplan–Meier curve showed no difference in the risk for cardiovascular mortality, all-cause mortality or HF-related hospitalization. We showed renal protective effect of neprilysin inhibition in HF patients and specified that subgroups with LVEF ≥ 40% or eGFR ≥ 60 mL/min/1.73 m2 were sensitive to this effect, suggesting an optimal subgroup of this treatment.Hui-Ling HsiehChun-You ChenCheng-Hsien ChenShih-Chang HsuWen-Cheng HuangYuh-Mou SueFeng-Yen LinChun-Ming ShihYue-Cune ChangPo-Hsun HuangChung-Te LiuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hui-Ling Hsieh Chun-You Chen Cheng-Hsien Chen Shih-Chang Hsu Wen-Cheng Huang Yuh-Mou Sue Feng-Yen Lin Chun-Ming Shih Yue-Cune Chang Po-Hsun Huang Chung-Te Liu Renal protective effect of sacubitril/valsartan in patients with heart failure
description	Abstract Sacubitril/valsartan is a combined neprilysin inhibitor/angiotensin II receptor blocker designed for treatment of heart failure (HF). Nonetheless, its renal protective effect remained an issue of debate. This retrospective cohort study investigated the renal protective effect of sacubitril/valsartan in HF patients. HF patients on sacubitril/valsartan or valsartan for > 30 days were matched for gender, age, estimated glomerular filtration rate (eGFR), and left ventricular ejection fraction (LVEF) to be enrolled into analysis. The follow-up period was 18 months. The outcomes included end eGFR, renal function decline defined as 20% reduction of eGFR, mortality, and HF-related hospitalization. Each group had 137 patients after matching. The mean age was 72.7 years and 65.7% were male. Mean eGFR was 70.9 mL/min/1.73 m2 and LVEF was 54.0% at baseline. Overall, the eGFR of sacubitril/valsartan groups was significantly higher than valsartan group at the end (P < 0.01). Subgroup analysis showed that the difference in eGFR was significant in subgroups with LVEF ≥ 40% or eGFR ≥ 60 mL/min/1.73 m2. Multivariate Cox regression model showed that sacubitril/valsartan group had significantly reduced risk for renal function decline (hazard ratio: 0.5, 95% confidence interval: 0.3–0.9). Kaplan–Meier curve showed no difference in the risk for cardiovascular mortality, all-cause mortality or HF-related hospitalization. We showed renal protective effect of neprilysin inhibition in HF patients and specified that subgroups with LVEF ≥ 40% or eGFR ≥ 60 mL/min/1.73 m2 were sensitive to this effect, suggesting an optimal subgroup of this treatment.
format	article
author	Hui-Ling Hsieh Chun-You Chen Cheng-Hsien Chen Shih-Chang Hsu Wen-Cheng Huang Yuh-Mou Sue Feng-Yen Lin Chun-Ming Shih Yue-Cune Chang Po-Hsun Huang Chung-Te Liu
author_facet	Hui-Ling Hsieh Chun-You Chen Cheng-Hsien Chen Shih-Chang Hsu Wen-Cheng Huang Yuh-Mou Sue Feng-Yen Lin Chun-Ming Shih Yue-Cune Chang Po-Hsun Huang Chung-Te Liu
author_sort	Hui-Ling Hsieh
title	Renal protective effect of sacubitril/valsartan in patients with heart failure
title_short	Renal protective effect of sacubitril/valsartan in patients with heart failure
title_full	Renal protective effect of sacubitril/valsartan in patients with heart failure
title_fullStr	Renal protective effect of sacubitril/valsartan in patients with heart failure
title_full_unstemmed	Renal protective effect of sacubitril/valsartan in patients with heart failure
title_sort	renal protective effect of sacubitril/valsartan in patients with heart failure
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/946ef0408dc44a6cae1072af72b69f17
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Renal protective effect of sacubitril/valsartan in patients with heart failure

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