SACUBITRIL/VALSARTAN ON CLINICAL, LABORATORY, AND ECHOCARDIOGRAPHIC VARIABLES IN HONDURANS WITH HEART FAILURE WITH REDUCED LEFT VENTRICULAR EJECTION FRACTION. FIVE YEARS EXPERIENCE

Abstract

Objective: This study aimed to describe the response to sacubitril/valsartan in a group of Hondurans with heart failure and reduced Left Ventricular Ejection Fraction (LVEF) between January 2018 and December 2022. Design and method: This observational, descriptive, retrospective cohort study was conducted on 216 adult patients with heart failure and reduced Left Ventricular Ejection Fraction (LVEF) who received treatment with angiotensin-receptor antagonist/neprilysin inhibitors (sacubitril/valsartan) in two medical center in Honduras. The study participants included the patients with LVEF < 40% treated with sacubitril/valsartan for at least one year. The patients also received optimal medical therapy for HFrEF according to the American Heart Association -guidelines. Results: This study was conducted on 216 patients with HFrEF treated with SAC/VAL. The median age of the patients was 71 years. The sociodemographic and clinical variables have been presented in Table 1. Treatment with SAC/VAL was done at three dosages (24/26 mg, 49/51 mg, and 97/103 mg) twice a day. For most of the patients, the treatment was started with 24/26 mg and the dose was progressively titrated to the maximum tolerated dose. 60% completed the follow-up at the optimal dose of 97/103 mg. All the patients had at least one underlying comorbidity. The main comorbidity was hypertension (92.4%) followed by dyslipidemia (61.9%) At the beginning of the study, 64.8%, 29.5% and 5.7% of the patients were in NYHA functional classes IV, III, and II, respectively. Following six months of treatment with SAC/VAL, 58.1% of the patients were in the functional class II, 28.6% were in class III, 9.5% were in class IV and 3.8% were in class I. Based on the results, 82.9% of the patients (n = 180) presented improvement, 16.2% (n = 34) had unchanged functional classes, and 1% showed worse baseline conditions (Figure 1). The results revealed the improvement of LVEF in 94.3% of the cases after treatment with SAC/VAL, while 3.8% presented no changes in this regard. Conclusions: The study population had sociodemographic and clinical similarities with the Latin American Cohort in the PARADIGM-HF trial with the significant improvement of the LVEF and functional class.