Long-term effects of angiotensin receptor neprilysin inhibitor therapy in heart failure patients with reduced ejection fraction: A retrospective cohort study
Özet
Heart failure is an increasing public health issue with substantial morbidity and mortality rates. This study aimed to evaluate the efficacy, safety, and long-term outcomes of angiotensin receptor neprilysin inhibitor (ARNi) in the treatment of heart failure with reduced ejection fraction (HFrEF) 5 years after treatment initiation. This retrospective study analyzed a cohort of 75 patients diagnosed with HFrEF over a period of 5 years after the initiation of ARNi therapy. The initial clinical condition, laboratory and echocardiographic measurements including left ventricular ejection fraction (LVEF), New York Heart Association functional classes (NYHA-FC) and the prognostic nutritional index were compared to the corresponding values obtained after a 5-year period of ARNi therapy. In addition, the number of annual hospitalizations, mortality rates and any history of adverse effects during the follow-up period were recorded. The N-terminal pro-brain natriuretic peptide (NT-proBNP) level, LVEF, and NYHA-FC values demonstrated significant improvement at the end of the 5-year follow-up period (all parameters, P <.001). Although the observed increase in the prognostic nutritional index was not statistically significant (P =.077), it is worth noting. A significant reduction in daily diuretic doses and hospitalizations due to heart failure was observed following the use of ARNi (all comparisons, P <.001). The prevalence of hypotension was around 16% (being symptomatic in 4%), making it the most frequently observed adverse event. The 5-year cardiovascular mortality rate was 17.3%. The use of ARNi in HFrEF patients was associated with a notable improvement in NYHA-FC, LVEF, and NT-proBNP levels in the long-term, while also leading to a better nutritional status and reduced need for diuretics and annual hospitalization. Additionally, ARNi usage has been associated with improved nutritional status, decreased reliance on diuretics, and reduced frequency of annual hospitalizations. These effects were associated with a lack of significant increase in adverse effects. These results may contribute to a better understanding of ARNi's long-term effects on patient outcomes. © 2023 Lippincott Williams and Wilkins. All rights reserved.
Kaynak
Medicine (United States)Cilt
102Sayı
43Koleksiyonlar
İlgili Öğeler
Başlık, yazar, küratör ve konuya göre gösterilen ilgili öğeler.
-
Spontan gebelikle doğan infantlarla yardımcı üreme teknikleriyle doğan infantlar arasındaki kardiyak fonksiyon farklılıkları ve konjenital kardiyak anomali sıklığının değerlendirilmesi
Öktem, Ahmet (Ufuk Üniversitesi, 2011)Son yıllarda, spontan olarak bebek sahibi olamayan aileler, çocuk sahibiolabilmek için yardımcı üreme tekniklerine başvurmaktadır. Bu tekniklerinkullanılmaya başlandığı günden bugüne kadar pek çok çalışmada yardımcı ... -
Cardiac autonomic function in patients with rheumatoid arthritis: Heart rate turbulence analysis
Avşar, A.; Onrat, E.; Evcik, D.; Çelik, A.; Kilit, C.; Günay, N.K.; Kavuncu, V. (AVES, 2011)Objective: Rheumatoid arthritis (RA) is a chronic systemic disease. The risk of cardiovascular morbidity and mortality is high in patients with RA. Heart rate turbulence (HRT) expresses ventriculophasic sinus arrhythmia ... -
Gestasyonel diyabetin fetal kardiyak morfoloji ve fonksiyonlar üzerine etkisi
Atik, Fatih (Ufuk Üniversitesi, 2011)Gelişen teknolojiye paralel olarak, fetal gelişimi olumsuz etkileyen, doğumsal kalphastalıklarının daha sık karşımıza çıkmasına yol açan faktörleri erken dönemdesaptayabilmekteyiz. Fetal kalpte morfolojik ve fonksiyonel ...