ArticleOpen heart2024
Risk stratification by renal function and NYHA class in patients with hypotension initiated on sacubitril/valsartan: a retrospective cohort study from 17 centres in Japan.
Article in Open heart, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Impacts of Sacubitril-Valsartan versus Valsartan on Left Ventricular Remodeling and Cardiac Function in Patients with Ischemic Heart Failure and Reduced Ejection Fraction: A Randomized Double-blinded Controlled Trial.Cardiovascular & hematological disorders drug targets · 2026Trial
- MAGGIC risk score and drug-related adverse events of sacubitril/valsartan: Insights from the REVIEW-HF registry.International journal of cardiology. Heart & vasculature · 2025Article
- Harnessing ARNI in advanced CKD - a new frontier for cardiac and renal protection.International urology and nephrology · 2025Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with heart failure exhibiting low systolic blood pressure (SBP) have a poor prognosis. Sacubitril/valsartan reduces cardiovascular events; however, its use in patients with low SBP has not been fully examined. Therefore, in this study, we aimed to investigate the association between baseline SBP and adverse events (AEs) in patients starting sacubitril/valsartan therapy using data from a real-world registry in Japan.
methodsWe analysed data from a multicentre retrospective study, including patients who initiated sacubitril/valsartan between August 2020 and August 2021. The patients were categorised into five groups based on their baseline SBP (<100, 100-109, 110-119, 120-129 and ≥130 mm Hg). The composite of AEs occurring within 3 months according to baseline SBP and the patient characteristics associated with AEs in a baseline SBP <110 mm Hg were analysed.
resultsAmong the 964 patients newly prescribed sacubitril/valsartan, the median (IQR) age was 73 (61-80) years, and 388 (40.2%) patients had a baseline SBP <110 mm Hg. AEs occurred in 24% (n=232) of patients. The adjusted ORs for all AEs were 1.91 (95% CI (CI) 1.13-3.23; p=0.02) for the SBP <100 mm Hg group and 3.33 (95% CI 1.98 to 5.59; p<0.001) for the SBP 100-109 mm Hg group, compared with the SBP 110-119 mm Hg group. In patients with a baseline SBP <110 mm Hg, factors associated with an increased risk of AEs included a higher New York Heart Association class (II, III or IV) and a lower estimated glomerular filtration rate <30 mL/min/1.73 m
conclusionsCaution is needed when initiating sacubitril/valsartan in patients with lower baseline SBP. The severity of heart failure and kidney function may be useful for risk stratification in these high-risk patients.
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