Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(8), 930–936. https://doi.org/10.1002/clc.24075 Xiaoyan Liu et al.
Points
- The study assessed the effectiveness and safety of sacubitril-valsartan (LCZ696) in chronic heart failure (CHF) patients with end-stage renal disease (ESRD) on dialysis.
- LCZ696 treatment significantly reduced rehospitalization for HF (43.28% vs. 73.47% in the control group).
- There was no significant difference in mortality between the LCZ696 group and the control group (8.96% vs. 10.20%).
- The Kaplan–Meier curve analysis showed that the LCZ696 group had a significantly longer free-event survival time over a 1-year follow-up.
- LCZ696 is effective and safe in CHF patients with ESRD on dialysis, filling a crucial gap in clinical data for this specific patient population.
Summary
In a recent study, the efficacy and safety of the angiotensin receptor–neprilysin inhibitor (ARNI) sacubitril-valsartan (LCZ696) were investigated in the context of chronic heart failure (CHF) patients with end-stage renal disease (ESRD requiring dialysis). Before this research, data on the effects of LCZ696 in this specific patient population were limited. The study’s objective was to determine whether LCZ696 treatment could reduce rehospitalization rates for heart failure (HF), delay the occurrence of HF rehospitalization, and extend overall survival time.
To achieve this, the researchers conducted a retrospective analysis of clinical data from CHF patients with ESRD on dialysis admitted to the Second Hospital of Tianjin Medical University between August 2019 and October 2021. Their findings revealed that 73.47% of patients in the control group experienced rehospitalization for HF, a significantly higher rate than the 43.28% observed in the LCZ696 group. Moreover, the study included a time-to-event analysis through 1 year for the primary outcome. The Kaplan–Meier curve displayed that the LCZ696 group had a significantly longer free-event survival time than the control group over this 1-year follow-up, with a median survival time of 139.0 days for the LCZ696 group, compared to 116.0 days for the control group and a p-value of 0.037, further supporting the efficacy of LCZ696.
However, the study also found no significant difference in mortality between the two groups, with mortality rates of 8.96% and 10.20% for the control and LCZ696 groups, respectively. This data underscores that while LCZ696 significantly reduced the incidence of HF rehospitalization, it did not significantly impact overall mortality rates. In conclusion, the findings of this study suggest that LCZ696 treatment effectively reduces the rehospitalization of HF in patients with ESRD on dialysis without causing significant alterations in serum creatinine and serum potassium levels. This research addresses a critical gap in available clinical data and highlights the safety and efficacy of LCZ696 as a promising therapeutic option for CHF patients with ESRD.
Link to the article: https://www.ajo.com/article/S0002-9394(23)00352-5/pdf
References Liu, X., Huang, L., Tse, G., Liu, T., & Che, J. (2023). Effects of sacubitril-valsartan in the treatment of chronic heart failure patients with end-stage renal disease undergoing dialysis. Clinical Cardiology, 46(8), 930–936. https://doi.org/10.1002/clc.24075
