Background
Among patients with heart failure and reduced ejection fraction (HFrEF, left ventricular
[LV] EF ≤40%), sacubitril/valsartan (S/V) has favorable effects on biomarkers, health
status, and reverse cardiac remodeling.
Objectives
To determine racial and ethnic differences in the magnitude of changes in biomarkers,
reverse cardiac remodeling, and health status in HFrEF patients treated with S/V.
Methods
This was a planned analysis of the Prospective Study of Biomarkers, Symptom Improvement
and Ventricular Remodeling During Entresto Therapy for Heart Failure study.
Results
178 Non-Hispanic Black, 117 Hispanic, and 487 Non-Hispanic White patients were included
in this analysis. Non-Hispanic Black and Hispanic patients had lower baseline NT-proBNP
concentrations compared to Non-Hispanic White patients; Hispanic patients had lower
baseline indexed LV end-diastolic or end-systolic volumes (LVEDVi, LVESVi). Following
initiation of S/V, NT-proBNP concentrations decreased across all 3 groups and each
group showed significant improvements in LVEF, LVEDVi, and LVESVi by Month 12, which
were associated with NT-proBNP reduction. Changes in remodeling measures among Non-Hispanic
Black patients were comparable or greater to Non-Hispanic White patients. Improvements
in Kansas City Cardiomyopathy Questionnaire-23 Total Symptom (KCCQ TS) scores were
largest among Hispanic patients and NT-proBNP reduction was associated with improvements
in KCCQ TS scores in Hispanic and Non-Hispanic White patients. Treatment with S/V
was well-tolerated.
Conclusions
Treatment with S/V associated with improvements in NT-proBNP, health status, and cardiac
remodeling, however patterns and magnitude of change were racial/ethnic-specific and
merit further research (PROVE-HF, NCT02887183).
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Copyright
© 2020 Published by Elsevier Inc.
