Sacubitril/Valsartan is useful and safe in elderly people with heart failure and reduced ejection fraction. Data from a real-word cohort |
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| Institution: | 1. Servicio de Cardiología, Hospital Universitario de Móstoles, Madrid, Spain;2. Universidad Rey Juan Carlos, Madrid, Spain;3. Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain;4. Servicio de Cardiología, Hospital Universitario Gregorio Marañón, CIBERCV, Madrid, Spain;5. Servicio de Cardiología, Hospital Universitario Clínico San Carlos, Madrid, Spain;6. Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Madrid, Spain;7. Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain;8. Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain;9. Universidad Complutense, Universidad Europea, Madrid, Spain;1. Programa de Memoria y del Centro de Envejecimiento Saludable, Ayuntamiento de Málaga, Málaga, España;2. Unidad de Geriatría, Hospital Universitari de Bellvitge, IDIBELL, ĹHospitalet de Llobregat, Barcelona, España;1. Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain;2. Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain;3. Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Madrid, Spain;4. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain;5. Servicio de Cardiología, Hospital Universitario Clínico de San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain;6. Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain;7. Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain;8. Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain;9. Servicio de Cardiología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain;10. Servicio de Cardiología, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain;11. Servicio de Cardiología, Hospital de Getafe, Getafe, Madrid, Spain;12. Universidad Complutense, Universidad Europea, Madrid, Spain;1. Cardiac MR PET CT Program, Department of Radiology and Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;2. Division of Cardiology, Department of Internal Medicine, Bronx-Lebanon Hospital Center of Icahn School of Medicine at Mount Sinai, Bronx, New York;3. Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;4. Division of Infectious Diseases, Department of Medicine and Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;5. Yale New-Haven Hospital of Yale University School of Medicine, New Haven, Connecticut;6. Divisions of Infectious Diseases and General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;7. Program in Nutritional Metabolism, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;1. The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China;2. The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China;3. Yuebei People''s Hospital, Shaoguan, China;4. Dongguan Hospital of Traditional Chinese Medicine, Dongguan, China;5. Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, China;6. Guangdong second Traditional Chinese Medicine Hospital, Guangzhou, China;7. Xiangya Hospital, Central South University, Changsha, China;8. Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou, China;9. The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China |
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| Abstract: | BackgroundHF elderly patients are underrepresented in Sacubitril/Valsartan HF trials, and the effect of S/V in real-life patients with advanced age is unknown. The aim of this study was to evaluate the use and safety of S/V in a real-word cohort of elderly patients.MethodsWe performed a prospective registry of patients who started S/V in clinical practice. We compared baseline characteristics, adverse events during follow-up and causes of S/V withdrawal according to age.ResultsA total of 427 patients started treatment with S/V: 222 (52.0%) < 70 years old, 140 (32.8%) between 70 and 79 and 65 (15.2%) ≥ 80. During a mean follow-up of 7.0 ± 0.1 months S/V was well tolerated, with no age-related differences in adverse events (26.8%, 25.9%, 23.1% respectively; p = 0.83). Symptomatic hypotension tended to be more frequent in the elderly (19.8%, 25.6%, 33.3% respectively; p = 0.17). The withdrawal of S/V was more frequent in younger patients (14.4%, 10.0%, 4.6% respectively; p = 0.05) and related to poor prognosis (HR 13.51, 95% CI 3.22–56.13, p < 0.001).ConclusionsSacubitril/Valsartan is useful and safe in elderly people with HF-rEF in real-life clinical practice, and withdrawal is associated to poor prognosis. The doses achieved are lower in elderly people. |
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| Keywords: | Sacubitril/Valsartan Elderly Safety Sacubitril/valsartán Ancianos Seguridad |
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