Retrospective real-world study on effectiveness and safety of sacubitril/valsartan in Indian patients with heart failure

OBJECTIVE: This study aimed to evaluate the clinical, biochemical, and functional outcomes of sacubitril/valsartan therapy in Indian patients with heart Failure (HF) with reduced ejection fraction (HFrEF) in routine practice. METHODS: We conducted a retrospective, single-centre, observational study at The Heart Clinic, New Delhi, India. Adult patients (≥18 years) with the New York Heart Association (NYHA) class II-IV HF who were newly initiated on sacubitril/valsartan and had ≥12 months of follow-up were included in the study. Clinical, echocardiographic, and biochemical data were extracted from the electronic medical records. The primary outcomes at 12 months were changes in left ventricular ejection fraction (LVEF), NYHA classification, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, estimated glomerular filtration rate (eGFR), and the number of patients receiving the maximum dose of sacubitril/valsartan. The secondary outcomes were cardiovascular and all-cause mortality. RESULTS: =0.088). Over half of the cohort (52.3%) achieved a target dose of 200 mg twice daily. No cardiovascular or all-cause deaths were observed. CONCLUSION: In this real-world Indian cohort, sacubitril/valsartan was associated with significant improvements in systolic function, functional class, and NT-proBNP levels, with preserved renal function and good tolerability. These findings support the use of sacubitril/valsartan as a cornerstone therapy for HFrEF management in routine clinical practice.