Savvy Nandal
The Northern Hospital, Australia
Title: Improvement in quality of life score, NYHA class and tolerability of valsartan/ sacubitril in patients with heart failure with reduced ejection fraction
Biography
Biography: Savvy Nandal
Abstract
Heart failure is a major cause of morbilidty and mortality worldwide. PARADIGM-HF study demonstrated Valsartan/ sacubitril (Entresto) decrease HF hospitalisation, cardiovascular mortality and all-cause mortality in patients with HF with reduced ejection fraction (HFrEF). Since addition of Entresto to Australian Pharmaceutical Benefit Scheme in June 2017, there has been considerable uptake of this drug. The aim of this study was to assess efficacy, tolerability and complications of Entresto with real-word evidence. We identified patients who were commenced on Entresto from 1/6/2017 to 30/11/2017 at a tertiary centre in Victoria, Australia via pharmacy dispensing database. 33 patients were commenced on Entresto with median age of 65; median EF was 31% with 57% secondary to ischaemic cardiomyopathy. 27 out of 33 patients were followed up via phone/ clinic/ patient records with three deaths in the time period. There was strong correlation in improvement in quality of life scores (EQ5D), pre vs post: 50 vs 65, (p value <0.05), New York Heart Association (NYHA) class (p value <0.05) and average BP reduction from 119 (101,137) to 110 (95,125) since commencement of Entresto. Commencement dose of Entresto was 24/26 mg in 60% patients and was up titrated in 37%. Only 14% were able to able to achieve recommenced maximal dose (97/103 mg). The commonest side effect was symptomatic hypotension, which led to dose reductions or complete cessation. Our study provides evidence that Entresto results in symptom improvement in addition to BP reduction in patients with HRrEF as well as common side effects of this drug. Further research is required to demonstrate whether these outcomes are sustained in the longer-term as well raise awareness of this novel therapy in the primary care setting.
Recent Publications
1. McMurray J J V, et al (2014) "Angiotensin-neprilysin inhibition versus enalapril in heart failure". The New Englan Journal of Medicine 371(11):993-1004.