Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Real World
Univ Glasgow, Scotland.
Soder Sjukhuset, Sweden.
Univ Glasgow, Scotland.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Karolinska Inst, Sweden.ORCID iD: 0000-0001-6353-8041
Show others and affiliations
2019 (English)In: Cardiovascular Drugs and Therapy, ISSN 0920-3206, E-ISSN 1573-7241, Vol. 33, no 3, p. 315-322Article in journal (Refereed) Published
Abstract [en]

PurposePARADIGM-HF demonstrated the superiority of sacubitril/valsartan over enalapril in patients with heart failure and reduced ejection fraction (HF-REF). How widely applicable sacubitril/valsartan treatment is in unselected patients with HF-REF is not known. We examined eligibility of patients with HF-REF for treatment with sacubitril/valsartan, according to the criteria used in PARADIGM-HF, in the Swedish Heart Failure Registry (SwedeHF).MethodsPatients were considered potentially eligible if they were not hospitalized, had symptoms (NYHA class II-IV) and a reduced LVEF (40%), and were prescribed an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) at a dose equivalent to enalapril 10mg daily. In these patients, we evaluated further eligibility according to the main additional PARADIGM-HF inclusion criteria.ResultsOf 12,866 outpatients in NYHA functional class II-IV with an LVEF 40%, 9577 were prescribed at least 10mg of enalapril (or equivalent) daily. Complete additional data were available for 3099 of these patients (32.4%) and of them 75.5% were potentially eligible for treatment with sacubitril/valsartan. The most common reason for ineligibility was a low natriuretic peptide level (n=462, 14.9%). Only a small proportion of patients were ineligible due to low eGFR or serum potassium level. Because only 78% of patients were taking 10mg enalapril or equivalent daily, only 58.9% of all patients (75.5% of 78%) were eligible for sacubitril/valsartan.ConclusionsBetween 34 and 76% of symptomatic patients with HF-REF in a real world population are eligible for treatment with sacubitril/valsartan, depending on background ACEI/ARB dose. The most common reason for ineligibility is a low natriuretic peptide level.

Place, publisher, year, edition, pages
SPRINGER , 2019. Vol. 33, no 3, p. 315-322
Keywords [en]
Heart failure; Eligibility; Sacubitril-valsartan; Real-world population; PARADIGM-HF
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-158048DOI: 10.1007/s10557-019-06873-1ISI: 000469352900006PubMedID: 30903545OAI: oai:DiVA.org:liu-158048DiVA, id: diva2:1330168
Note

Funding Agencies|Swedish National board of Health and Welfare; Swedish Association of Local Authorities and Regions; Swedish Society of Cardiology; Swedish Heart-Lung Foundation

Available from: 2019-06-25 Created: 2019-06-25 Last updated: 2019-11-04

Open Access in DiVA

fulltext(338 kB)3 downloads
File information
File name FULLTEXT01.pdfFile size 338 kBChecksum SHA-512
74fee16ca327d7f218c7b10369ee83167d00fcec3099a0b0414c7f813450fbd5155d15bfffc2a5d3ee0ba024d1066cbe733195c58d438c5a0b51f117b3e738f7
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Dahlström, Ulf
By organisation
Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Cardiology in Linköping
In the same journal
Cardiovascular Drugs and Therapy
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
Total: 3 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 5 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf