Evidence map›Paper›PMID 33020255›Full record

ArticleOpen heart2020

Real-world treatment switching to sacubitril/valsartan in patients with heart failure with reduced ejection fraction: A cohort study.

Sashiananthan Ganesananthan, Nisar Shah, Parin Shah, Hossam Elsayed, Julie Phillips, Ann Parkes, Angharad Morgan, Zaheer Yousef

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PubMed Full text at PMC Publisher
In one paragraph

Article in Open heart, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

8 authors.

Sashiananthan GanesananthanSchool of Medicine, Cardiff University, Cardiff, UK GanesananthanS@cardiff.ac.uk.ORCID 0000-0001-7503-7527
Nisar ShahDepartment of Cardiology, University Hospital of Wales, Cardiff, UK.
Parin ShahDepartment of Cardiology, University Hospital of Wales, Cardiff, UK.
Hossam ElsayedDepartment of Cardiology, University Hospital of Wales, Cardiff, UK.
Julie PhillipsDepartment of Cardiology, University Hospital of Wales, Cardiff, UK.
Ann ParkesDepartment of Cardiology, University Hospital of Wales, Cardiff, UK.
Angharad MorganHealth Economics and Outcomes Research Ltd, Cardiff University, Cardiff, South Glamorgan, UK.
Zaheer YousefDepartment of Cardiology, University Hospital of Wales, Cardiff, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSacubitril/valsartan is an effective treatment for heart failure with reduced ejection fraction (HFrEF) based on clinical trial data. However, little is known about its use or impact in real-world practice. The aim of this study was to describe our routine clinical experience of switching otherwise optimally treated patients with HFrEF to sacubitril/valsartan with respect to patient outcomes such as quality of life (QoL) and echocardiographic variables. METHODS AND

resultsFrom June 2017 to May 2019, 80 consecutive stable patients with HFrEF on established and maximally tolerated guideline-directed HF therapies were initiated on sacubitril/valsartan with bimonthly uptitration. Clinical assessment, biochemistry, echocardiography and QoL were compared pretreatment and post-treatment switching. We were able to successfully switch 89% of patients from renin-angiotensin axis inhibitors to sacubitril/valsartan (71 of 80 patients). After 3 months of switch therapy, we observed clinically significant and incremental improvements in blood pressure (systolic blood pressure 123 vs 112 mm Hg, p<0.001; diastolic blood pressure 72 vs 68 mm Hg, p=0.004), New York Heart Association functional classification score (2.3 vs 1.9, p<0.001), Minnesota Living with Heart Failure Questionnaire score (46 vs 38, p=0.016), left ventricular ejection fraction (26% vs 33%, p<0.001) and left ventricular end systolic diameter (5.2 vs 4.9 cm, p=0.013) compared with baseline. There were no significant changes in renal function or serum potassium.

conclusionThis study provides real-world clinical practice data demonstrating incremental improvements in functional and echocardiographic outcomes in optimally treated patients with HFrEF switched to sacubitril/valsartan. The data provide evidence beyond that observed in clinical trial settings of the potential benefits of sacubitril/valsartan when used as part of a multidisciplinary heart failure programme.

Indexed as

Drug SubstitutionAgedAminobutyratesAngiotensin II Type 1 Receptor BlockersBiphenyl CompoundsDrug CombinationsEchocardiographyFemaleHeart FailureHumansMaleMiddle AgedNeprilysinProtease InhibitorsQuality of LifeRecovery of FunctionAminobutyratesAngiotensin II Type 1 Receptor BlockersBiphenyl CompoundsDrug CombinationsNeprilysinProtease Inhibitorssacubitril and valsartan sodium hydrate drug combinationTetrazolesValsartanheart failureheart failure treatmentsystolic heart failure

Identifiers

PMID33020255
PMCPMC7537464

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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.