030| Volume 26, ISSUE 10, SUPPLEMENT , S13, October 2020

Racial and Ethnic Differences in Biomarkers, Health Status, and Cardiac Remodeling in Patients with Heart Failure with Reduced Ejection Fraction Treated with Sacubitril/valsartan


      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.


      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.


      This was a planned analysis of the Prospective Study of Biomarkers, Symptom Improvement and Ventricular Remodeling During Entresto Therapy for Heart Failure study.


      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.


      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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