Uso de sacubitril/valsartán en pacientes hospitalizados en vida real

Abstract

Sacubitril/valsartán es un inhibidor combinado del enzima neprilisina y del receptor de la angiotensina II. Empleado en pacientes con insuficiencia cardiaca sistólica ha demostrado reducir la mortalidad cardiovascular y los ingresos hospitalarios en comparación con enalapril. Además, presenta un perfil de seguridad comparable. Sin embargo, su tolerancia en poblaciones reales es hasta el momento desconocida. El objetivo primario de este trabajo es perfilar la seguridad y tolerancia de sacubitril/valsartán al ser introducido en una población real hospitalizada y compararlo, en primer lugar, con los resultados del estudio Sacubitril/Valsartan Versus Enalapril on Effect on NT-pro BNP in Patients Stabilized From an Acute Heart Failure Episode (PIONEER-HF), y en segundo lugar con una cohorte no seleccionada de pacientes ambulatorios...Sacubitril/valsartan is safe when initiated during hospitalization in a clinical trial setting. Its safety in real-life population is not stablished. We compared the initiation of sacubitril/valsartan during hospitalization in a non-selected population, in Sacubitril/Valsartan Versus Enalapril on Effect on NT-proBNP in the Patients Stabilized From an Acute Heart Failure Episode (PIONEER-HF) trial, and in non-selected outpatients. Methods. Multicentre registry including 527 patients: 100 were started on sacubitril/valsartan during hospitalization (19.0%) and 427 as outpatients (81.0%). Clinical, analytical, and echocardiographic variables, previous therapies, and the starting dose of sacubitril/valsartan and its modification or suspension were collected throughout the follow-up...