Evidence map›Paper›PMID 31903729›Full record

ArticleESC heart failure2020

Sacubitril-Valsartan in a routine community population: attention to volume status critical to achieving target dose.

Rebabonye B Pharithi, Maria Ferre-Vallverdu, Alan S Maisel, Eoin O'Connell, Myra Walshe, Claire Sweeney, James Barton, Kathrine McDonald, Daniel O'Hare, Chris Watson and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.

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  7. Haemodynamic Effects of Sacubitril/Valsartan Initiation in Outpatients with Chronic Heart Failure.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2022
    Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 3 countries.

Rebabonye B PharithiHeart Failure Unit, St. Vincent University Hospital Health Care Group, Elm Park, Dublin, DO4 T6F4, Ireland.ORCID 0000-0001-5504-2978
Maria Ferre-VallverduHeart Failure Unit, St. Vincent University Hospital Health Care Group, Elm Park, Dublin, DO4 T6F4, Ireland.
Alan S MaiselDivision of Cardiovascular Medicine, Coronary Care Unit and Heart Failure Programme, Veterans Affairs San Diego Healthcare System, University of San Diego, San Diego, USA, CA.
Eoin O'ConnellHeart Failure Unit, St. Vincent University Hospital Health Care Group, Elm Park, Dublin, DO4 T6F4, Ireland.
Myra WalsheHeart Failure Unit, St. Vincent University Hospital Health Care Group, Elm Park, Dublin, DO4 T6F4, Ireland.
Claire SweeneyHeart Failure Unit, St. Vincent University Hospital Health Care Group, Elm Park, Dublin, DO4 T6F4, Ireland.
James BartonHeart Failure Unit, St. Vincent University Hospital Health Care Group, Elm Park, Dublin, DO4 T6F4, Ireland.
Kathrine McDonaldUniversity College Dublin, Belfield, Dublin, Ireland.
Daniel O'HareHeart Failure Unit, St. Vincent University Hospital Health Care Group, Elm Park, Dublin, DO4 T6F4, Ireland.
Chris WatsonUniversity College Dublin, Belfield, Dublin, Ireland.
Joe GallagherHeart Failure Unit, St. Vincent University Hospital Health Care Group, Elm Park, Dublin, DO4 T6F4, Ireland.
Mark LedwidgeHeart Failure Unit, St. Vincent University Hospital Health Care Group, Elm Park, Dublin, DO4 T6F4, Ireland.
Kenneth McDonaldHeart Failure Unit, St. Vincent University Hospital Health Care Group, Elm Park, Dublin, DO4 T6F4, Ireland.
St Vincent Hospital · USUniversity College Dublin · IEUniversity of San Diego · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsIn the PARADIGM-heart failure trial, sacubitril-valsartan demonstrated a reduction in heart failure admissions and reduced all-cause mortality in patients with heart failure with reduced ejection fraction. Although real world data have shown similar benefits regarding efficacy and safety, there has been difficulty in achieving the target dose (TD). The factors preventing the achievement of TD remains unclear. This study assesses the tolerability, ability to achieve, and factors linked to attaining TD in a routine clinical population. METHODS AND

resultsThis is a retrospective single-centre review of patients switched from angiotensin-converting enzyme inhibitors/angiotensin receptor blockers to sacubitril-valsartan between May 2016 and August 2018. Baseline and follow-up clinical characteristics and biomarker profiles were collected. Univariate and multivariate analyses were used to analyse predictors of achieving TD. Clinical response to sacubitril-valsartan was defined as a reduction in N terminal pro BNP of ≥30%, or an increase in left ventricular ejection fraction of ≥5% compared with baseline values. To date, a total of 322 patients (75% male patients) have been switched to sacubitril-valsartan. Those still in the titration phase were excluded (n = 25). Sacubitril-valsartan was not tolerated in 40 patients (12.4%). Those intolerant were older (73.4 years [68.3, 80.6] vs. 69.1 years [61.2, 76]; P = 0.003) and had worse renal function with estimated glomerular filtration rate (53.5 mL/min/1.72 m

conclusionsSacubitril-valsartan was well tolerated. Achievement of TD was possible in the majority of the cohort and was linked to response metrics. Reduction in diuretic was required in a large percentage of the population and was the strongest predictor of attaining TD. Therefore, careful clinical attention to volume status assessment is essential to maximising the benefits of sacubitril-valsartan.

Indexed as

AminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsHeart FailureNeprilysinValsartanAgedAngiotensin-Converting Enzyme InhibitorsDrug CombinationsFemaleHumansMaleRetrospective StudiesStroke VolumeTreatment OutcomeVentricular Function, LeftAminobutyratesAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug CombinationsNeprilysinsacubitril and valsartan sodium hydrate drug combinationValsartanDiuretic dose decreaseHeart failureHF-rEFReal worldSacubitril-ValsartanTarget dose

Identifiers

PMID31903729
PMCPMC7083433
OpenAlexW3000273876

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.