Key result
Sacubitril/valsartan significantly improved the effective rate of cardiac function recovery (82.56% vs 65.52%) compared to conventional therapy in patients with chronic heart failure after cardiac valve surgery.
Why the study?
The study was conducted to evaluate the efficacy of sacubitril/valsartan for treating patients with chronic heart failure after cardiac valve surgery.
Does sacubitril/valsartan improve cardiac function and symptoms in patients with chronic heart failure after cardiac valve surgery?
Cohort (n=259)
No
Does sacubitril/valsartan improve cardiac function and symptoms in patients with chronic heart failure after cardiac valve surgery?
Absolute Event Rate: 82.56% vs 65.52%
p-value: p=<0.001
Sacubitril/valsartan safely and effectively improves symptoms, left ventricular ejection fraction, and ventricular remodeling in patients with chronic heart failure following cardiac valve surgery.
Should not yet change post-valve surgery HF practice; leaves open benefit pending randomized confirmation.
OBJECTIVES: To evaluate the efficacy of sacubitril/valsartan for the treatment of patients with chronic heart failure (CHF) after cardiac valve surgery (CVS). METHODS: Data were collected from 259 patients who underwent CVS due to valvular heart disease and were admitted to the hospital with CHF from January 2018 to December 2020. The patients were divided into Group A (treatment with sacubitril/valsartan) and Group B (treatment without sacubitril/valsartan). The duration of treatment and follow-up was 6 months. The two groups' prior and clinical characteristics, post-treatment data, mortality, and follow-up data were analysed. RESULTS: The effective rate of Group A was higher than that of Group B (82.56% versus 65.52%, P < 0.05). The left ventricular ejection fraction (LVEF, %) was improved in both groups. The final value minus the initial value was (11.14 ± 10.16 versus 7.15 ± 11.18, P = 0.004). The left ventricular end-diastolic/-systolic diameter (LVEDD/LVESD, mm) in Group A decreased more than in Group B. The final value minus the initial value was (-3.58 ± 9.21 versus - 0.27 ± 14.44, P = 0.026; -4.21 ± 8.15 versus - 1.14 ± 12.12, P = 0.016, respectively). Both groups decreased the N-terminal prohormone of B-type natriuretic peptide (NT-proBNP, pg/ml). The final value minus initial value was [-902.0(-2226.0, -269.5) versus - 535.0(-1738, -7.0), P = 0.029]. The systolic and diastolic blood pressure (SBP/DBP, mmHg) in Group A decreased more than in Group B. The final value minus the initial value was (-13.13 ± 23.98 versus - 1.81 ± 10.89, P < 0.001; -8.28 ± 17.79 versus - 2.37 ± 11.41, P = 0.005, respectively). Liver and renal insufficiency, hyperkalaemia, symptomatic hypotension, angioedema, and acute heart failure had no statistical differences between the two groups. CONCLUSIONS: Sacubitril/valsartan can effectively improve the cardiac function of patients with CHF after CVS by increasing LVEF and reducing LVEDD, LVESD, NT-proBNP, and BP, with good safety.
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Zheng et al. (2023) conducted a cohort in Chronic heart failure after cardiac valve surgery (n=259). Sacubitril/valsartan vs. Conventional anti-heart failure therapy was evaluated on Effective rate (NYHA cardiac function grade improved by ≥1 grade) (p=<0.001). Sacubitril/valsartan significantly improved the effective rate of cardiac function recovery (82.56% vs 65.52%) compared to conventional therapy in patients with chronic heart failure after cardiac valve surgery.
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