Key result
Sacubitril/valsartan induced delayed-onset (8 to 18 hours) and prolonged (3 to 6 days) first-dose hypotension in a patient with heart failure.
Case Report (n=1)
Sacubitril/valsartan can cause delayed and prolonged first-dose hypotension, highlighting the need for extended monitoring after initiation.
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May warrant extended monitoring after sacubitril/valsartan initiation; hypothesis-generating case report that leaves open generalizability.
Entresto was recommanded by major guidelines as the frontline therapy for heart failure with reduced ejection fraction since its clinical benefit was proved by the PARADIGM-HF trial. Angiotensin converting enzyme inhibitors are the cornerstone of the treatment of HF. Varying incidences of first-dose hypotension have been reported and recognized as a potential limiting factor for prescribing. According to previous reports, the onset of hypotension mostly occur 3-5 hours after the first dose. However, the pattern of entresto-related hypotension has not been reported. We present a case of HF, who had delay onset (about 8 to 18 hours) and prolonged (3 to 6 days) first-dose hypotension. Further investigation is required to illustrate this phenomenon.
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Hsiao et al. (2018) conducted a case report in Heart failure (n=1). Sacubitril/Valsartan was evaluated on First-dose hypotension characteristics. Sacubitril/valsartan induced delayed-onset (8 to 18 hours) and prolonged (3 to 6 days) first-dose hypotension in a patient with heart failure.
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