Sudden death prophylaxis in heart failure

Rosanio, Salvatore; Schwarz, Ernst R.; Vitarelli, Antonio; Zarraga, Ignatius Gerardo E.; Kunapuli, Sanjay; Ware, David L.; Birnbaum, Yochai; Tuero, Enrique; Uretsky, Barry F.

doi:10.1016/j.ijcard.2006.11.021

Cited by 7 publications

(4 citation statements)

References 47 publications

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“…Sudden cardiac death is the leading cause of mortality in HF (37). In most cases, SCD is triggered by ventricular arrhythmias 10.3389/fcvm.2022.943377 (38).…”

Section: Discussionmentioning

confidence: 99%

Effect of sacubitril/valsartan on the occurrence of cardiac arrhythmias and the risk of sudden cardiac death in heart failure: A meta-analysis of randomized controlled trials

et al. 2022

Front. Cardiovasc. Med.

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BackgroundSacubitril/valsartan therapy reduced the risks of death and of hospitalization for heart failure (HF). HF and cardiac arrhythmias have shared physiological mechanisems. Therefore, sacubitril/valsartan may exhibit anti-arrhythmic properties in HF. The purpose of this study was to evaluate the effect of sacubitril/valsartan on the occurrence of cardiac arrhythmias and the risk of sudden cardiac death (SCD) in HF.MethodsThis meta-analysis was performed according to PRISMA guidelines. We searched PubMed and Embase (from inception up to 6 February 2022) to identify randomized control trials (RCTs) on the effect of sacubitril/valsartan on the occurrence of cardiac arrhythmias and the risk of SCD in HF. Primary outcomes were the occurrence of atrial arrhythmias, ventricular arrhythmias, and SCD. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model for meta-analysis.ResultsWe included 9 RCTs (published between 2012 and 2021) with 18,500 patients (9,244 sacubitril/valsartan vs. 9,256 active control). Enalapril and valsartan were used as active control in six and two studies, respectively. Follow-up ranged from 2 to 35 months. The cumulative occurrence of events was 76, 13, and 48 per 1,000 patient-years for atrial arrhythmias, ventricular arrhythmias and SCD, respectively. There was no significant association between sacubitril/valsartan therapy and the occurrence of atrial arrhythmias (RR 1.06; 95% CI: 0.97–1.17; P = 0.19) and ventricular arrhythmias (RR 0.86; 95% CI 0.68–1.10; P = 0.24). However, sacubitril/valsartan therapy significantly reduced the risk of SCD (RR 0.79; 95% CI 0.70–0.90; P = 0.03) compared with control.ConclusionNo association between sacubitril/valsartan therapy and the occurrence of atrial and ventricular arrhythmias was found, but sacubitril/valsartan therapy significantly reduced the risk of SCD.

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“…Sudden cardiac death is the leading cause of mortality in HF (37). In most cases, SCD is triggered by ventricular arrhythmias 10.3389/fcvm.2022.943377 (38).…”

Section: Discussionmentioning

confidence: 99%

Effect of sacubitril/valsartan on the occurrence of cardiac arrhythmias and the risk of sudden cardiac death in heart failure: A meta-analysis of randomized controlled trials

et al. 2022

Front. Cardiovasc. Med.

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“…The presented immunohistochemical investigation can contribute to elucidate the cardiovascular pathophysiology of fatal DCM, suggesting that anti-TNFα strategies may be useful in the management of initial clinical stage of DCM by enhancing cardiac function or by preventing sudden death [6,7].…”

Section: Discussionmentioning

confidence: 99%

Myocardial tumor necrosis factor-alpha expression in a sudden death due to dilated cardiomyopathy with endomyoelastofibrosis

Riezzo

Pomara

Neri

et al. 2009

International Journal of Cardiology

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“…Sudden cardiac death (SCD) represents the major cause of death in HF patients [ 107 ]. As the most robust parameter related to SCD, reduced LVEF is considered as an indication for implantable cardioverter-defibrillator (ICD) implantation for primary prevention of SCD [ 108 ].…”

Section: S/v In Hf and Beyondmentioning

confidence: 99%

Sacubitril/valsartan in Heart Failure and Beyond—From Molecular Mechanisms to Clinical Relevance

Nikolic¹,

Srejović²,

Jovic³

et al. 2022

Rev. Cardiovasc. Med.

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As the ultimate pathophysiological event, heart failure (HF) may arise from various cardiovascular (CV) conditions, including sustained pressure/volume overload of the left ventricle, myocardial infarction or ischemia, and cardiomyopathies. Sacubitril/valsartan (S/V; formerly termed as LCZ696), a first-in-class angiotensin receptor/neprilysin inhibitor, brought a significant shift in the management of HF with reduced ejection fraction by modulating both renin-angiotensin-aldosterone system (angiotensin II type I receptor blockage by valsartan) and natriuretic peptide system (neprilysin inhibition by sacubitril) pathways. Besides, the efficacy of S/V has been also investigated in the setting of other CV pathologies which are during their pathophysiological course and progression deeply interrelated with HF. However, its mechanism of action is not entirely clarified, suggesting other off-target benefits contributing to its cardioprotection. In this review article our goal was to highlight up-to-date clinical and experimental evidence on S/V cardioprotective effects, as well as most discussed molecular mechanisms achieved by this dual-acting compound. Although S/V was extensively investigated in HF patients, additional large studies are needed to elucidate its effects in the setting of other CV conditions. Furthermore, with its antiinflamatory potential, this agent should be investigated in animal models of inflammatory heart diseases, such as myocarditis, while it may possibly improve cardiac dysfunction as well as inflammatory response in this pathophysiological setting. Also, discovering other signalling pathways affected by S/V should be of particular interest for basic researches, while it can provide additional understanding of its cardioprotective mechanisms.

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Sudden death prophylaxis in heart failure

Cited by 7 publications

References 47 publications

Effect of sacubitril/valsartan on the occurrence of cardiac arrhythmias and the risk of sudden cardiac death in heart failure: A meta-analysis of randomized controlled trials

Effect of sacubitril/valsartan on the occurrence of cardiac arrhythmias and the risk of sudden cardiac death in heart failure: A meta-analysis of randomized controlled trials

Myocardial tumor necrosis factor-alpha expression in a sudden death due to dilated cardiomyopathy with endomyoelastofibrosis

Sacubitril/valsartan in Heart Failure and Beyond—From Molecular Mechanisms to Clinical Relevance

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