Effects of sacubitril-valsartan in the treatment of chronic heart failure patients with end-stage renal disease undergoing dialysis

Clin Cardiol. 2023 Aug;46(8):930-936. doi: 10.1002/clc.24075. Epub 2023 Jun 28.

Abstract

Background: The data on the effects of the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril-valsartan (LCZ696) in chronic heart failure (CHF) patients with end-stage renal disease (ESRD) requiring dialysis are lacking. This study assessed the efficacy and safety of LCZ696 in CHF patients with ESRD on dialysis.

Hypothesis: LCZ696 treatment can reduce rehospitalization rate for HF, delay the occurrence of rehospitalization for HF, and prolong the survival time.

Methods: We retrospectively analyzed the clinical data of CHF patients with ESRD on dialysis who were admitted to the Second Hospital of Tianjin Medical University from August 2019 to October 2021.

Results: Sixty-five patients had primary outcome during the follow-up. The incidence of rehospitalization for HF in the control group was significantly higher than that in the LCZ696 group (73.47% vs. 43.28%, p = .001). There was no significant difference in mortality between the two groups (8.96% vs. 10.20%, p = 1.000). Our study included a time-to-event analysis through 1 year for the primary outcome-Kaplan-Meier curve showed that the LCZ696 group had significantly longer free-event survival time than the control group over 1-year follow-up (median survival time 139.0 days vs. 116.0 days, p = .037).

Conclusions: Our study found that LCZ696 treatment was associated with a reduction in HF rehospitalization without significant effects on serum creatinine and serum potassium levels. LCZ696 is effective and safe in CHF patients with ESRD on dialysis.

Keywords: chronic heart failure; dialysis; end-stage renal disease; sacubitril-valsartan.

MeSH terms

  • Aminobutyrates / adverse effects
  • Angiotensin Receptor Antagonists / adverse effects
  • Biphenyl Compounds / therapeutic use
  • Chronic Disease
  • Drug Combinations
  • Heart Failure* / diagnosis
  • Heart Failure* / drug therapy
  • Humans
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / diagnosis
  • Kidney Failure, Chronic* / therapy
  • Renal Dialysis / adverse effects
  • Retrospective Studies
  • Stroke Volume
  • Tetrazoles / adverse effects
  • Treatment Outcome

Substances

  • sacubitril and valsartan sodium hydrate drug combination
  • Tetrazoles
  • Angiotensin Receptor Antagonists
  • Aminobutyrates
  • Biphenyl Compounds
  • Drug Combinations