Clinical Effectiveness of Sacubitril/Valsartan Among Patients Hospitalized for Heart Failure With Reduced Ejection Fraction
Why the study?
Sacubitril/valsartan is efficacious in randomized trials, but its effectiveness in older patients hospitalized for HFrEF in real-world US practice was unclear.
Does sacubitril/valsartan prescribed at discharge reduce mortality and hospitalizations in older patients hospitalized for HFrEF compared to ACEi/ARB or no prescription?
Population
Medicare beneficiaries age >=65 years hospitalized for HFrEF <=40% in GWTG-HF
Comparison
Discharge prescription of sacubitril/valsartan vs ACEI/ARB or no sacubitril/valsartan
Design
Registry-based retrospective cohort study using inverse probability of treatment weighting
Follow-up
12-month
Authors
Discussion
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Member takes
Implication
Sacubitril/valsartan at discharge was associated with lower mortality versus ACEI/ARB in older HFrEF patients; supports effectiveness but leaves open randomized confirmation.
Structured PICO
Does sacubitril/valsartan prescribed at discharge reduce mortality and hospitalizations in older patients hospitalized for HFrEF compared to ACEi/ARB or no prescription?
P
Population
Medicare beneficiaries age ≥65 years hospitalized for HFrEF (LVEF ≤40%) in the Get With The Guidelines–Heart Failure registry between October 2015 and December 2018, eligible for sacubitril/valsartan.
I
Intervention
Sacubitril/valsartan prescribed at discharge.
C
Comparator
Angiotensin-converting enzyme inhibitor (ACEi) or angiotensin II receptor blocker (ARB) prescribed at discharge, or no sacubitril/valsartan prescription.
O
Outcome
All-cause mortality over 12-month follow-up.hard clinical
In real-world US practice, prescribing sacubitril/valsartan at discharge for older patients hospitalized with HFrEF is associated with reduced 12-month mortality compared to ACEi/ARB.
Cite This Study
Greene et al. (2021) studied this question.