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Effect of sacubitril/valsartan on cardiac remodeling compared with other renin–angiotensin system inhibitors: a difference-in-difference analysis of propensity-score matched samples

Carluccio, Erberto ; Dini, Frank L. ; Correale, Michele ; Dattilo, Giuseppe ; Ciccarelli, Michele ; Vannuccini, Francesca ; Sforna, Stefano ; Pacileo, Giuseppe ; Masarone, Daniele ; Scelsi, Laura ; Ghio, Stefano ; Tocchetti, Carlo Gabriele ; Mercurio, Valentina ; Brunetti, Natale Daniele ; Nodari, Savina ; Ambrosio, Giuseppe ; Palazzuoli, Alberto

Clinical research in cardiology, 2024-06, Vol.113 (6), p.856-865 [Periódico revisado por pares]

Berlin/Heidelberg: Springer Berlin Heidelberg

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Título:
Effect of sacubitril/valsartan on cardiac remodeling compared with other renin–angiotensin system inhibitors: a difference-in-difference analysis of propensity-score matched samples
Autor: Carluccio, Erberto ; Dini, Frank L. ; Correale, Michele ; Dattilo, Giuseppe ; Ciccarelli, Michele ; Vannuccini, Francesca ; Sforna, Stefano ; Pacileo, Giuseppe ; Masarone, Daniele ; Scelsi, Laura ; Ghio, Stefano ; Tocchetti, Carlo Gabriele ; Mercurio, Valentina ; Brunetti, Natale Daniele ; Nodari, Savina ; Ambrosio, Giuseppe ; Palazzuoli, Alberto
Assuntos: Aged ; Aminobutyrates - therapeutic use ; Angiotensin ; Angiotensin Receptor Antagonists - therapeutic use ; Angiotensin-converting enzyme inhibitors ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Beta blockers ; Biphenyl Compounds ; Cardiology ; Congestive heart failure ; Drug Combinations ; Echocardiography ; Ejection fraction ; Enzyme inhibitors ; Female ; Heart Failure - drug therapy ; Heart Failure - physiopathology ; Humans ; Male ; Matching ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Paper ; Peptidyl-dipeptidase A ; Propensity Score ; Renin ; Renin-Angiotensin System - drug effects ; Retrospective Studies ; Stroke Volume - drug effects ; Stroke Volume - physiology ; Tetrazoles - therapeutic use ; Treatment Outcome ; Valsartan - therapeutic use ; Ventricular Function, Left - drug effects ; Ventricular Function, Left - physiology ; Ventricular Remodeling - drug effects
É parte de: Clinical research in cardiology, 2024-06, Vol.113 (6), p.856-865
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
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Descrição: Background In patients with heart failure with reduced ejection fraction (HFrEF), treatment with sacubitril–valsartan (S/V) may reverse left ventricular remodeling (rLVR). Whether this effect is superior to that induced by other renin–angiotensin system (RAS) inhibitors is not well known. Methods HFrEF patients treated with S/V ( n = 795) were compared, by propensity score matching, with a historical cohort of 831 HFrEF patients (non-S/V group) treated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (RAS inhibitors). All patients were also treated with beta-blockers and shared the same protocol with repeat echocardiogram 8–12 months after starting therapy. The difference-in-difference (DiD) analysis was used to evaluate the impact of S/V on CR indices between the two groups. Results After propensity score matching, compared to non-S/V group ( n = 354), S/V group ( n = 354) showed a relative greater reduction in end-diastolic and end-systolic volume index (ESVI), and greater increase in ejection fraction (DiD estimator = + 5.42 mL/m 2 , P = 0.0005; + 4.68 mL/m 2 , P = 0.0009, and + 1.76%, P = 0.002, respectively). Reverse LVR (reduction in ESVI ≥ 15% from baseline) was more prevalent in S/V than in non-S/V group (34% vs 26%, P = 0.017), while adverse LVR (aLVR, increase in ESVI at follow-up ≥ 15%) was more frequent in non-S/V than in S/V (16% vs 7%, P < 0.001). The beneficial effect of S/V on CR over other RAS inhibitors was appreciable across a wide range of patient’s age and baseline end-diastolic volume index, but it tended to attenuate in more dilated left ventricles ( P for interaction = NS for both). Conclusion In HFrEF patients treated with beta-blockers, sacubitril/valsartan is associated with a relative greater benefit in LV reverse remodeling indices than other RAS inhibitors. Graphical abstract
Editor: Berlin/Heidelberg: Springer Berlin Heidelberg
Idioma: Inglês

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Effect of sacubitril/valsartan on cardiac remodeling compared with other renin–angiotensin system inhibitors: a difference-in-difference analysis of propensity-score matched samples

Berlin/Heidelberg: Springer Berlin Heidelberg

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