Heterogeneity of health status treatment response with sacubitril/valsartan: insights from the CHAMP‐HF registry

ESC Heart Failure

卷:8

Gregg C. Fonarow¹  Nancy M. Albert²  Ann Hellkamp³  Laine Thomas³  Carol I. Duffy⁴  Yevgeniy Khariton⁵  John A. Spertus⁵  Michael E. Nassif⁵  Javed Butler⁶ 

[1] Ahmanson‐UCLA Cardiomyopathy Center Ronald Reagan UCLA Medical Center Los Angeles CA USA;

[2] Cleveland Clinic Cleveland OH USA;

[3] Duke Clinical Research Institute Durham NC USA;

[4] Novartis Pharmaceuticals Corporation East Hanover NJ USA;

[5] Saint Luke's Mid America Heart Institute University of Missouri‐Kansas City 4401 Wornall Road Kansas City MO 64111 USA;

[6] University of Mississippi Jackson MS USA;

关键词: Chronic heart failure;    Health status;    Quality of life;    Angiotensin‐neprilysin inhibitor;   

DOI  :  10.1002/ehf2.12981

来源: DOAJ

【 摘 要 】

Abstract Aims The aim of our study was to investigate heterogeneity of health status treatment response of sacubitril/valsartan in patients with heart failure with reduced ejection fraction (HFrEF). Methods and results We leveraged data from CHAMP‐HF, an observational registry of 140 US clinics and 5026 outpatients with chronic HFrEF, where health status was serially assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ)‐12 Overall Summary Scale (range from 0 to 100; ≥20‐point improvement is a very large improvement). In 334 patients newly initiated on sacubitril/valsartan, we used hierarchical multivariable logistic regression (13 patient‐level characteristics as well as baseline KCCQ‐12 score) to calculate the odds ratio (OR) of any characteristic being associated with a very large health status improvement. A total of 104/334 (31.1%) of patients achieved the primary endpoint, where only worse baseline health status [KCCQ‐12 score of 0–60 points had an OR = 0.86/5‐point higher score (CI 0.79, 0.93)], and those with a KCCQ‐12 score of 60–80 points had an OR = 0.61/5‐point higher score (0.45–0.82), which was associated with a very large benefit. No other patient characteristic was associated with a very large health status improvement (P > 0.05). Conclusions We found that, after initiation of sacubitril/valsartan, only worse baseline health status was associated with very large health status improvement. Accordingly, a trial of therapy—particularly in those with worse symptoms, function, and quality of life—and assessing treatment response are likely to be the best prospective strategy.

【 授权许可】

Unknown