Key result
Pre-transplant sacubitril/valsartan exposure was not significantly associated with the development of vasoplegic syndrome after heart transplantation (7.14% vs 17.07% without exposure).
Why the study?
Vasoplegic syndrome is associated with poor outcomes after heart transplantation, but whether sacubitril/valsartan is associated with vasoplegic syndrome after transplantation was unknown.
Does sacubitril/valsartan treatment at the time of transplant increase the risk of vasoplegic syndrome in heart transplant recipients?
Cohort (n=96)
Yes
Does sacubitril/valsartan treatment at the time of transplant increase the risk of vasoplegic syndrome in heart transplant recipients?
Pre-transplant use of sacubitril/valsartan does not appear to be associated with an increased risk of post-operative vasoplegic syndrome in heart transplant recipients.
Answers are grounded in this paper and cite their sources.
Pre-HT sacubitril/valsartan showed no VS association; leaves open safety confirmation in larger prospective studies.
Vasoplegic syndrome (VS) is associated with poor outcomes after heart transplantation (HT). Our aim was to determine whether SAC/VALS is associated with VS after HT. We retrospectively analyzed all consecutive HT performed in three centers between January 2017 and August 2018. VS was defined as vasopressor need (norepinephrine or epinephrine >.5 mcg/kg/min or vasopressin) for more than 24 hours to maintain a mean arterial pressure >70 mm Hg. Ninety-six recipients underwent HT in the study period: 60 elective HT with no LVAD, 5 elective HT on long term LVAD, and 31 emergent HT: 3 on long-term LVAD and 28 on temporary mechanical circulatory support. Fourteen patients were on SAC/VALS treatment at the time of transplant, and 82 were not. The global incidence of VS was 15.6%, with no significant differences between the groups (7.14% in with SAC/VALS vs 17.07% in no-SAC/VALS). In conclusion, in our small cohort SAC/VALS was not associated with VS development.
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Dominguez et al. (2020) conducted a cohort in Heart transplantation (n=96). Sacubitril/valsartan vs. No sacubitril/valsartan was evaluated on Vasoplegic syndrome. Pre-transplant sacubitril/valsartan exposure was not significantly associated with the development of vasoplegic syndrome after heart transplantation (7.14% vs 17.07% without exposure).
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