Assessment of Prescription Pattern and Clinical Outcomes of Sacubitril/Valsartan in Heart Failure Patients with Reduced Ejection Fraction

Objectives: The objective of the study is to examine the prescription patterns, efficacy, and tolerability of sacubitril/valsartan in patients with heart failure and reduced ejection fraction (HFrEF). Material and Methods: A 5-month prospective observational study took place at a hospital in Kerala, India, involving 50 HFrEF patients prescribed sacubitril/valsartan. Participants were aged >18 years and excluded if pregnant, diagnosed with cancer, or had stage 4/5 chronic kidney disease. Clinical parameters, including EF, blood pressure (BP), serum potassium, and creatinine, were evaluated at baseline and follow-up. Changes in left ventricular (LV) dysfunction and New York Heart Association (NYHA) functional class were additionally determined. Results: The cohort comprised 72% male and 28% female patients. Common comorbidities included diabetes (30%), hypertension (16%), and concurrent diabetes and hypertension (20%). Prescription patterns showed no sex-based variation, with doses of 50 mg and 100 mg used. From baseline to follow-up, a statistically significant enhancement was observed in EF (36.80 ± 5.993% to 38.12 ± 4.922%; P = 0.021), LV dysfunction ( P = 0.002), and NYHA class ( P = 0.005). Serum potassium, creatinine, and systolic/diastolic BP demonstrated no significant changes, though a slight, non-significant decrease in systolic BP was noted (131.57 ± 18.699 mmHg to 130.57 ± 11.554 mmHg). The treatment was well tolerated with no cases of significant symptomatic hypotension, hyperkalemia, or edema. Conclusion: In this short-term study, sacubitril/valsartan was effective in improving EF, LV function, and NYHA class in HFrEF patients, with good tolerability at the prescribed doses. Larger, long-term investigations are recommended for validating present results.