Effects of Sacubitril/Valsartan dose on sociodemographic and clinical predictor variables: an Irish cross-sectional study.

Abstract

Background: The syndrome of heart failure is a recognised epidemic affecting between 1%-2% of adults in the developed world. Several landmark clinical trials have led to improvements in heart failure management over the past two decades. Aims: We examined the association between socio-demographic and clinical variables and change in ejection fraction (EF), and whether age affected improvement in EF, New York Heart Association (NYHA) classification and estimated glomerular filtration rate (eGFR) following higher doses of Sacubitril/Valsartan. Methods: In this cross-sectional Irish study, we used descriptive and inferential statistical analyses. Results: We had post Sacubitril/ Valsartan EF measurements on 162 people, and 198 measures for both NYHA classification and eGFR post Sacubitril/ Valsartan. With a dose of 97mg/103mg, twice daily, patients had 7.70 (2.812 – 21.078) times higher odds of improvement in EF than those who received the lower dose of 24mg/26mg twice daily. Irrespective of drug dose administered, patients under 65 years have a greater improvement in EF, relative to those over 65 years. Patients with myocardial infarction (MI) history had lower odds of EF improvement than those with no MI history. There was no association between age and improvement in NYHA or eGFR. Conclusion: Sacubitril/Valsartan is effective in improving ejection fraction. This improvement is greater among patients under 65 years. Higher dosages lead to higher odds of improvement, when adjusted for age and history of myocardial infarction.