PCV6 Sacubitril/Valsartan and Its IMPACT on Sudden Death in Heart Failure Patients in Portugal

Abstract

Sudden death is an important cause of death among patients with heart failure (HF) and a reduced ejection fraction (HFrEF), even in less symptomatic patients. We aimed to estimate the number of sudden deaths avoided with sacubitril/valsartan versus enalapril in a population of HF patients in Portugal. A Markov model calibrated with data from the PARADIGM-HF trial was used to describe HFrEF progression and associated outcomes, including sudden death. The model was adapted to the Portuguese reality based on the EPICA HF epidemiologic study. Drug discontinuation was not considered. Results are reported as sudden deaths estimated to be avoided following treatment with sacubitril/valsartan versus enalapril in a population of HF patients in Portugal. A 5-year time horizon was considered. By May 2020, a total of 13,076 HF patients were on treatment with sacubitril/valsartan in Portugal. For this population, assuming a mean age of 65 years and 56% women (based on the EPICA study), sacubitril/valsartan may potentially avoid 287 sudden deaths versus enalapril in a 5-year period of time. Out of this, 143 sudden deaths avoided are estimated to be among women. If assumed that the population of patients treated with sacubitril/valsartan is older (mean age of 70 years), 304 sudden deaths may potentially be avoided for the same time horizon. In this analysis, we estimate that sacubitril/valsartan may potentially avoid a substantial higher number of sudden deaths in HF patients than the current standard of care in Portugal. More awareness should be raised around the risk of sudden death in HF in order to maximize health outcomes.