NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction

Pascual-Figal, Domingo A.; Wachter, Rolf; Senni, Michele; Bao, Weibin; Noè, Adele; Schwende, H.; Butylin, Dmytro; Prescott, Margaret F.; Gniot, Jacek; Можейко, М Е; Lelonek, Małgorzata; Domínguez, A. Reyes; Horacek, Thomas; Rio, Enrique Garcia del; Kobalava, Z.; Mueller, Christian; Çavuşoğlu, Yüksel; Straburzyńska‐Migaj, Ewa; Slanina, Miroslav; Dahl, Juergen vom; Ryding, Alisdair; Moriarty, Andrew; Robles, Manuel Beltrán; Núñez, Julio; Quintana, Antonio García; Nitschke, Thorsten; Pinilla, José Manuel García; Bonet, Luis Almenar; Chaaban, Said; zaatari, Samia Filali; Špinar, Jindřich; Musiał, Włodzimierz J.; Abdelbaki, Khaled; Bělohlávek, Jan; Fehske, Wolfgang; Bott, Michael Carlos; Hoegalmen, Geir; Leiro, Marisa Crespo; Özcan, İsmail Türkay; Mullens, Wilfried; Kryza, Radim; Al-Ani, R; Łoboz‐Grudzień, Krystyna; Ermoshkina, Lyudmila; Hojerová, S.; Fernández, Alberto; Špinarová, Lenka; Lapp, Harald; Bulut, Efraim; Almeida, Filipa; Vishnevsky, A. A.; Belicová, Margita; Pascual, Domingo; Witte, Klaus; Wong, Kenneth; Droogné, Walter; Delforge, Marc; Peterka, M.; Olbrich, Hans-Georg; Carugo, Stefano; Nessler, Jadwiga; McGill, Thao Huynh; Huegl, Burkhard; Akın, İbrahim; Moreira, Ilídio; Багликов, А. Н.; Thambyrajah, Jeetendra; Hayes, Chris; Barrionuevo, Marcelo Raul; Yiğit, Zerrin; Kaya, Hakki; Klimsa, Zdeněk; Radvan, Martin; Kadel, C; Landmesser, Ulf; Tano, Giuseppe Di; Lisik, Malgorzata Buksinska; Fonseca, Cândida; Oliveira, L.; Marques, Irene; Santos, L.M.; Lenner, Egon; Letavay, Peter; Bueno, Manuel; Mota, Paula; Wong, Aaron; Bailey, Kristian; Foley, Paul; Hasbani, Eduardo; Virani, Sean; Massih, Tony Abdel; AlSaif, Shukri; Táborský, Miloš; Kaislerova, Marta; Motovska, Zuzana; Cohen, Aron Ariel; Logeart, Damien; Endemann, Dierk; Ferreira, Daniel; Brito, Dulce; Kycina, P; Bollano, Entela; Basilio, Enrique Galve; Fácila, Lorenzo; Aguado, Marcos Garcı́a; Schiavi, Lilia Beatriz; Zivano, Daniel Francisco; Lonn, Eva; Sayed, Ali El; Pouleur, Anne‐Catherine; Heyse, Alex; Schee, Alexandr; Polášek, Rostislav; Houra, M.; Tribouilloy, Christophe; Galinier, Michel; Noutsias, Michel; Schwimmbeck, Peter L.; Voigt, Ingo; Westermann, Dirk; Pulignano, Giovanni; Vegsundvaag, Johnny; Antunes, Alexandre; Monteiro, Pedro; Stevlik, Jan; Gonçalvesová, Eva; Hulkoova, Beata; Fernandez, Antonio; Davies, Ceri; Squire, Iain B.; Meyer, Philippe; Sheppard, Richard; Şahı̇n, Tayfun; Sochor, K; Geeter, Guillaume De; Schmeißer, Alexander; Weil, Joachim; Soares, Ana Oliveira; Vasilevna, Olga Bulashova; Oshurkov, Andrey; Sunderland, Shahid Junejo; Glover, Jason D.; Exequiel, Tomas; Decoulx, Eric; Meyer, Sven; Muenzel, Thomas; Friões, Fernando; Arbolishvili, G.; Tokárciková, A; Karlström, Patric; Vila, J.; Pérez, Gonzalo; Sankaranarayanan, Rajiv; Nageh, Thuraia; Alasia, Diego; Refaat, Marwan M.; Demirkan, Burcu; Al-Buraiki, Jehad; Karabsheh, Shadi

doi:10.1016/j.jchf.2020.05.012

Cited by 28 publications

(27 citation statements)

References 25 publications

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“…A higher probability of sac/val up-titration to target dose was found among patients with normal SBP (≥ 120 mmHg), preserved renal function (eGFR > 60 mL/ min/1.73 m), and de novo HF [29,30]. In a post hoc efficacy analysis, pre-discharge initiation of sac/val as compared to post-discharge was associated with a higher reduction of NT-proBNP levels and higher NT-ProBNP favorable reduction response [31].…”

Section: Sac/val In Ahf a Transition Studymentioning

confidence: 99%

“…Natriuretic peptides have been enthusiastically integrated in everyday clinical practice for risk stratification and guidance of HF management [53]. Recent data from the TRAN-SITION study show that a favorable NT-proBNP response 4 weeks after sac/val in-hospital initiation is associated with a lower risk for first HF rehospitalization or cardiovascular death [31]. Nevertheless, hospitalized patients with AHF are already at high risk for events, and thus, there is no need to check natriuretic peptides before sac/val initiation [2].…”

Section: Natriuretic Peptidesmentioning

confidence: 99%

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Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper

et al. 2021

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The short-term mortality and rehospitalization rates after admission for acute heart failure (AHF) remain high, despite the high level of adherence to contemporary practice guidelines. Observational data from non-randomized studies in AHF strongly support the in-hospital administration of oral evidence-based modifying chronic heart failure (HF) medications (i.e., b-blockers, ACE inhibitors, mineralocorticoid receptor antagonists) to reduce morbidity and mortality. Interestingly, a well-designed prospective randomized multicenter study (PIONEER-HF) showed an improved clinical outcome and stress/injury biomarker profile after in-hospital administration of sacubitril/valsartan (sac/val) as compared to enalapril, in hemodynamically stable patients with AHF. However, sac/val implementation during hospitalization remains suboptimal due to the lack of an integrated individualized plan or well-defined appropriateness criteria for transition to oral therapies, an absence of specific guidelines regarding dose selection and the up-titration process, and uncertainty regarding patient eligibility. In the present expert consensus position paper, clinical practical recommendations are proposed, together with an action plan algorithm, to encourage and facilitate sac/val administration during hospitalization after an AHF episode with the aim of improving efficiencies of care and resource utilization.

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Section: Sac/val In Ahf a Transition Studymentioning

confidence: 99%

Section: Natriuretic Peptidesmentioning

confidence: 99%

Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper

et al. 2021

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“…Po 10 týždňoch sledovania sa dosiahla cieľová dávka sakubitril/ valsartanu v oboch sledovaných skupinách asi u polovice pacientov, čo poukazuje na široký časový interval vhodný na iniciáciu terapie po akútnej kardiálnej dekompenzácii (30). Avšak nasadenie sakubitril/valsartanu pred prepustením viedlo k výraznejšej redukcii hladiny NT-proBNP, čo mierne uprednostňuje začatie terapie už počas hospitalizácie (31). Post-hoc analýza štúdie TRANSITION porovnala nasadenie a toleranciu terapie ARNi u skupín pacientov s kardiálnou dekompenzáciou v prípade de novo diagnózy SZ s pacientmi po kardiálnej dekompenzácii u predtým už detekovaného chronického SZ.…”

Section: Sakubitril/valsartan V Liečbe Sz So Zníženou Ejekčnou Frakciou ľK (Hfref)unclassified

Duálna inhibícia neprilyzínu a receptora typu 1 pre angiotenzín II vo svetle klinických štúdií / Dual inhibition of neprilysin and angiotensin II type 1 receptor in light of clinical studies

Mariani

Mattioli

Condorelli

et al. 2021

Cardiol

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Despite advances in heart failure (HF) pharmacotherapy over the last three decades, the residual mortality with HF remains high. The antipode to the drug-induced inhibition of vasoconstrictive and proliferative substances could be an increase of vasodilative and antiproliferative humoral substances, including the natriuretic peptides (NPs). NPs are secreted by the distended myocardium and stimulate diuresis and vasodilation, exert antiproliferative effects, and inhibit both the sympathetic and renin-angiotensin systems (RAS). The proteolytic enzyme neprilysin cleaves NPs and thus limits their effects. However, this non-specific protease degrades a variety of other proteins, including angiotensin II (Ang II). Therefore, neprilysin inhibition increases the level of both NPs and Ang II. Sacubitril/valsartan, a representative of the new drug class: angiotensin receptor-neprilysin inhibitors (ARNi), contains one molecule of Ang II type 1 receptor blocker (valsartan) and one molecule of neprilysin inhibitor (sacubitril). The interaction of these substances, ensuing potential increase of NPs without RAS activation, brings an additive morbidity and mortality benefit in the management of HF with reduced ejection fraction (HFrEF), as compared to RAS inhibition alone. Yet, the hope for ARNi's benefit in HF with preserved ejection fraction (HFpEF) remains is unmet. Preliminary studies suggest a potential benefit by ARNi in hypertensive heart disease, kidney protection and post-myocardial infarction cardiac remodelling. Tab. 1, Ref. 50, on-line full text (Free, PDF) www.cardiologyletters.sk

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“…Исследование TRANSICION, в которое было включено 46% пациентов с СД, показало, что терапию сакубитрил/валсартаном одинаково безопасно начинать у пациентов с острой декомпенсированной сердечной недостаточностью, как в условиях стационара сразу после стабилизации гемодинамики, так и на амбулаторном этапе вскоре после выписки [47][48][49][50]. В исследовании PIONEER-HF, в которое было включено 19% пациентов с СД, назначение сакубитрил/валсартана в стационаре после стабилизации при острой декомпенсации сердечной недостаточности сопровождалось снижением относительного риска по комбинированной клинической конечной точке (смерть, регоспитализация по причине ХСН, имплантация поддерживающих устройств ЛЖ, включение в лист ожидания трансплантации сердца) на 46% в течение 8 нед по сравнению с терапией ИАПФ [51].…”

Section: ингибитор неприлизина и рецепторов ангиотензинаunclassified

Management of Patients with Chronic Heart Failure and Diabetes Mellitus

Reznik

Nguyen

Голухов

2021

Racionalʹnaâ farmakoterapiâ v kardiologii

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Chronic heart failure (CHF) occurs in 4.3-28% of patients with diabetes mellitus and is most often associated with the presence of coronary heart disease, arterial hypertension and the direct adverse effects of insulin-resistance, hyperinsulinemia and hyperglycemia on the myocardium. Diabetes mellitus occurs in 12-47% of patients with CHF and can develop within several years after a diagnosis of HF in 22% of patients due to insulin-resistance of failure tissues. The presence of diabetes mellitus leads to a greater severity of clinical symptoms and hospitalization rate, worsening of quality of life and prognosis in CHF. A decreased left ventricular ejection fraction is an independent predictor of the poor prognosis in the patients with diabetes mellitus. The algorithm of the treatment of CHF in the patients with and without diabetes mellitus is not fundamentally different, but it requires taking into account the metabolic effects of the prescribed drugs. Angiotensin receptor-neprilysin inhibitor are increasingly used in clinical practice and are gradually replacing angiotensin-converting enzyme inhibitors and sartans in CHF both without diabetes mellitus and in its presence. Recently, the effectiveness of type 2 sodium glucose cotransporter inhibitors has been proven in patients with CHF with and without diabetes mellitus. This review is devoted to the relationship of diabetes mellitus and CHF, as well as the approaches to the management of such comorbid patients.

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NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction

Cited by 28 publications

References 25 publications

Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper

Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper

Duálna inhibícia neprilyzínu a receptora typu 1 pre angiotenzín II vo svetle klinických štúdií / Dual inhibition of neprilysin and angiotensin II type 1 receptor in light of clinical studies

Management of Patients with Chronic Heart Failure and Diabetes Mellitus

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