期刊
JOURNAL OF PHARMACY PRACTICE
卷 34, 期 3, 页码 454-458出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/0897190019878948
关键词
acute heart failure; pharmacotherapy; angiotensin receptor neprilysin inhibitor
The study aimed to identify risk factors for intolerance to inpatient initiation of sacubitril/valsartan, revealing that patients with newly diagnosed heart failure were more likely to tolerate the medication initiation; most inpatients tolerated the initiation of sacubitril/valsartan, suggesting the need for larger clinical trials.
Background: Sacubitril/valsartan has been shown to improve outcomes in patients with heart failure with reduced ejection fraction (HFrEF). However, initiation of sacubitril/valsartan has primarily been studied in stable, ambulatory patients with HFrEF. Objective: The objective of this study was to determine risk factors for intolerance to inpatient sacubitril/valsartan initiation. Methods: This was a retrospective, single-center study from August 1, 2015 through April 30, 2018. Patients were at least 18 years old and were newly initiated on sacubitril/valsartan during their hospitalization. Results: A total of 143 patients met inclusion criteria. Of these patients, 20.3% (n = 29) were intolerant to inpatient initiation of sacubitril/valsartan. The primary reason for intolerance was hypotension (n = 19, 65.5%). Patients with newly diagnosed heart failure were more likely to tolerate the initiation of sacubitril/valsartan (32.5% vs 10.3%; P = 0.03). No differences between groups were identified among other potential predictors for intolerance to sacubitril/valsartan, including systolic blood pressure, acutely decompensated heart failure, or serum creatinine. The most common adverse event was hypotension, which occurred in 26.6% (n = 38) of all patients. Conclusion: The majority of inpatients tolerated sacubitril/valsartan initiation. Larger, prospective, randomized controlled trials would be helpful in further determining ideal candidates for inpatient sacubitril/valsartan initiation.
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