Clinical efficacy of angiotensin receptor-neprilysin inhibitor in de novo heart failure with reduced ejection fraction
- Author:
Su Yeong PARK
1
;
Min Gyu KONG
;
Inki MOON
;
Hyun Woo PARK
;
Hyung-Oh CHOI
;
Hye Sun SEO
;
Yoon Haeng CHO
;
Nae-Hee LEE
;
Kwan Yong LEE
;
Ho-Jun JANG
;
Je Sang KIM
;
Ik Jun CHOI
;
Jon SUH
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2023;38(5):692-703
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:We aimed to analyze the efficacy of angiotensin receptor-neprilysin inhibitor (ARNI) by the disease course of heart failure (HF).
Methods:We evaluated 227 patients with HF in a multi-center retrospective cohort that included those with left ventricular ejection fraction (LVEF) ≤ 40% undergoing ARNI treatment. The patients were divided into patients with newly diagnosed HF with ARNI treatment initiated within 6 months of diagnosis (de novo HF group) and those who were diagnosed or admitted for HF exacerbation for more than 6 months prior to initiation of ARNI treatment (prior HF group). The primary outcome was a composite of cardiovascular death and worsening HF, including hospitalization or an emergency visit for HF aggravation within 12 months.
Results:No significant differences in baseline characteristics were reported between the de novo and prior HF groups. The prior HF group was significantly associated with a higher primary outcome (23.9 vs. 9.4%) than the de novo HF group (adjusted hazard ratio 2.52, 95% confidence interval 1.06–5.96, p = 0.036), although on a higher initial dose. The de novo HF group showed better LVEF improvement after 1 year (12.0% vs 7.4%, p = 0.010). Further, the discontinuation rate of diuretics after 1 year was numerically higher in the de novo group than the prior HF group (34.4 vs 18.5%, p = 0.064).
Conclusions:The de novo HF group had a lower risk of the primary composite outcome than the prior HF group in patients with reduced ejection fraction who were treated with ARNI.
