Key result
Older patients (>65 years) with HFrEF treated with sacubitril/valsartan had a significantly higher mortality rate compared to younger patients (14.5% vs 2.0%; P=0.04).
Why the study?
Sacubitril/valsartan improves left ventricular ejection fraction and reduces sudden cardiac death in chronic heart failure with reduced ejection fraction, but the impact of age differences on treatment outcomes required analysis.
Does age >65 years worsen outcomes and increase side effects in patients with chronic heart failure with reduced ejection fraction treated with sacubitril/valsartan compared to age ≤65 years?
Cohort (n=127)
Does age >65 years worsen outcomes and increase side effects in patients with chronic heart failure with reduced ejection fraction treated with sacubitril/valsartan compared to age ≤65 years?
In HFrEF patients treated with sacubitril/valsartan, older age (>65 years) is associated with higher mortality and more side effects compared to younger patients, though ventricular arrhythmia incidence is similar.
May warrant closer monitoring in older HFrEF patients on sacubitril/valsartan; leaves open confirmation in age-stratified RCTs.
The treatment with sacubitril/valsartan in patients suffering from chronic heart failure with reduced ejection fraction increases left ventricular ejection fraction and decreases the risk of sudden cardiac death. We conducted a retrospective analysis regarding the impact of age differences on the treatment outcome of sacubitril/valsartan in patients with chronic heart failure with reduced ejection fraction. Patients were defined as adults if ≤65 years (n = 51) and older if >65 years of age (n = 76). The incidence of ventricular arrhythmias at 1-year follow-up was comparable in both groups (30.8 vs 26.5%; p = 0.71). The mortality rate in adult patients is significantly lower as compared with older patients (2 vs 14.5%; log-rank = 0.04). Older patients may suffer remarkably more side effects than adult patients (21.1 vs 11.8%; p = 0.03).
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Abumayyaleh et al. (2021) conducted a cohort in Chronic heart failure with reduced ejection fraction (n=127). Age >65 years vs. Age ≤65 years was evaluated on Mortality rate (p=0.04). Older patients (>65 years) with HFrEF treated with sacubitril/valsartan had a significantly higher mortality rate compared to younger patients (14.5% vs 2.0%; P=0.04).
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