Comparison of the Prognosis and Outcome of Heart Failure With Reduced Ejection Fraction Patients Treated With sacubitril/valsartan According to Age

Abstract

The treatment with sacubitril/valsartan in patients suffering from chronic heart failure with reduced ejection fraction increases left ventricular ejection fraction and decreases the risk of sudden cardiac death. We conducted a retrospective analysis regarding the impact of age differences on the treatment outcome of sacubitril/valsartan in patients with chronic heart failure with reduced ejection fraction. Patients were defined as adults if ≤65 years (n = 51) and older if >65 years of age (n = 76). The incidence of ventricular arrhythmias at 1-year follow-up was comparable in both groups (30.8 vs 26.5%; p = 0.71). The mortality rate in adult patients is significantly lower as compared with older patients (2 vs 14.5%; log-rank = 0.04). Older patients may suffer remarkably more side effects than adult patients (21.1 vs 11.8%; p = 0.03).

Lay abstract

Many patients still die from heart failure (HF). Better drugs for this condition were developed over the past 20 years. The drug combination sacubitril/valsartan improves heart function and might lower the risk of sudden cardiac death from a fast heart rate (ventricular arrythmia). More research is needed on the effect of sacubitril/valsartan on older patients with HF. We wanted to see how sacubitril/valsartan affects older patients with HF. Seventy-six patients above 65 years of age were compared with 51 patients below 65 years. A year later, the number of ventricular arrhythmias was similar in both groups. Side effects were more common in older patients. At 2 years, there were more deaths in the older group. In summary, side effects of sacubitril/valsartan could be an obstacle to treating older patients. Finding better concepts to treat older patients with a weak heart remains necessary.

Keywords:

• adult patients
• age
• mortality rate
• older patients
• sacubitril/valsartan

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.