Evaluating the safety and tolerability of inpatient sacubitril/valsartan initiation in a community hospital.

Journal of Community Hospital Internal Medicine Perspectives
Katie L PeppinMartin W Schwarze

Abstract

Background: Sacubitril/valsartan has been incorporated into guidelines based on the results of the PARADIGM-HF trial, which demonstrated reduced mortality in stable patients with heart failure with reduced ejection fraction (HFrEF). Sacubitril/valsartan is recommended in addition to other HF therapies in place of an angiotensin-converting-enzyme inhibitor or angiotensin-receptor-blocker. Objectives: To evaluate the safety and tolerability of sacubitril/valsartan initiation in a community hospital. Design/methods: This single-center, retrospective review evaluated patients that received ≥24 hours of sacubitril/valsartan therapy August 2015-March 2018. The primary outcome included the incidence of hypotensive events during hospitalization. Secondary outcomes included: incidence of inpatient acute kidney injury (AKI) and hyperkalemia, rates of inpatient discontinuation, and change in ejection fraction (EF) ≥30 days after initiation. Results: Of the 59 patients included, 21 (35.6%) experienced a hypotensive event. A total of 6 patients (10.2%) discontinued therapy while inpatient, which was more likely in patients that developed AKI (n = 3; p = 0.005) or those who experienced a hypotensive event (n = 5; p = 0.018). There was a sign...Continue Reading

References

Mar 4, 2011·The New England Journal of Medicine·G Michael FelkerUNKNOWN NHLBI Heart Failure Clinical Research Network
Sep 2, 2014·The New England Journal of Medicine·John J V McMurrayUNKNOWN PARADIGM-HF Investigators and Committees
Jan 27, 2017·Circulation·Emelia J BenjaminUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
May 29, 2018·The Annals of Pharmacotherapy·Allison HelmerSean Smithgall
Nov 13, 2018·The New England Journal of Medicine·Eric J VelazquezUNKNOWN PIONEER-HF Investigators

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Citations

Aug 4, 2020·The Annals of Pharmacotherapy·Maya R ChilbertAshley E Woodruff

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Software Mentioned

PIONEER
SPSS
PARADIGM
HF

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