Filling an evidence gap, a pooled analysis of patients with heart failure 'across the LVEF spectrum' supports starting sacubitril-valsartan in the hospital.
Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. who are started on sacubitril-valsartan in the hospital or soon after discharge will see a sharp drop in clinical risk whether their ejection fraction is"reduced" or merely"below normal," suggests a combined analysis of two major studies.
The prespecified analysis of 1347 patients medically stabilized after a"worsening-HF event" was reported by Robert J. Mentz, MD, Duke Clinical Research Institute, Durham, North Carolina, on October 8 at the But the hypotension risk when starting the drug is manageable to some extent, observed Mentz."We can safely start sacubitril-valsartan in the hospital or early post-discharge, but we need to make sure their volume status is okay" and keep track of their blood pressure trajectory, he toldThose with initially low BP, unsurprisingly, seem more susceptible to the problem, Mentz said.
Patients in PIONEER-HF, with an LVEF 40% or lower, were started on their assigned drug during an acute-HF hospitalization and followed a median of 8 weeks. PARAGLIDE-HF patients, with LVEF higher than 40%, started therapy either in hospital or within 30 days of their HF event; they were followed a median of 6 months.
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