Influence of Sacubitril/Valsartan (LCZ696) on 30-Day Readmission After Heart Failure Hospitalization

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:68

Article

Desai, Akshay S.¹  Claggett, Brian L.¹  Packer, Milton²  Zile, Michael R.^3,4  Rouleau, Jean L.⁵  Swedberg, Karl^6,7  Shi, Victor⁸  Lefkowitz, Martin⁸  Starling, Randall⁹  Teerlink, John¹⁰  McMurray, John J. V.¹¹  Solomon, Scott D.¹ 

[1] Brigham & Womens Hosp, Div Cardiovasc, 75 Francis St, Boston, MA 02115 USA

[2] Baylor Univ, Med Ctr, Baylor Heart & Vasc Inst, Dallas, TX USA

[3] Med Univ South Carolina, Charleston, SC 29425 USA

[4] Ralph H Johnston Vet Adm Med Ctr, Charleston, SC USA

[5] Univ Montreal, Inst Cardiol, Montreal, PQ, Canada

[6] Univ Gothenburg, Dept Mol & Clin Med, Gothenburg, Sweden

[7] Imperial Coll, Natl Heart & Lung Inst, London, England

[8] Nova Pharmaceut Corp, E Hanover, NJ USA

[9] Cleveland Clin, Cardiol, Cleveland, OH 44106 USA

[10] Vet Affairs Med Ctr, Cardiol, San Francisco, CA 94121 USA

[11] Univ Glasgow, British Heart Fdn Cardiovasc Res Ctr, Glasgow, Lanark, Scotland

关键词: hospitalization;    neprilysin;    readmission;    sacubitril/valsartan;   

DOI  :  10.1016/j.jacc.2016.04.047

来源: Elsevier

【 摘 要 】

BACKGROUND Patients with heart failure (HF) are at high risk for hospital readmission in the first 30 days following HF hospitalization. OBJECTIVES This study sought to determine if treatment with sacubitril/valsartan (LCZ696) reduces rates of hospital readmission at 30-days following HF hospitalization compared with enalapril. METHODS We assessed the risk of 30-day readmission for any cause following investigator-reported hospitalizations for HF in the PARADIGM-HF trial, which randomized 8,399 participants with HF and reduced ejection fraction to treatment with LCZ696 or enalapril. RESULTS Accounting for multiple hospitalizations per patient, there were 2,383 investigator-reported HF hospitalizations, of which 1,076 (45.2%) occurred in subjects assigned to LCZ696 and 1,307 (54.8%) occurred in subjects assigned to enalapril. Rates of readmission for any cause at 30 days were 17.8% in LCZ696-assigned subjects and 21.0% in enalapril-assigned subjects (odds ratio: 0.74; 95% confidence interval: 0.56 to 0.97; p = 0.031). Rates of readmission for HF at 30-days were also lower in subjects assigned to LCZ696 (9.7% vs. 13.4%; odds ratio: 0.62; 95% confidence interval: 0.45 to 0.87; p = 0.006). The reduction in both all-cause and HF readmissions with LCZ696 was maintained when the time window from discharge was extended to 60 days and in sensitivity analyses restricted to adjudicated HF hospitalizations. CONCLUSIONS Compared with enalapril, treatment with LCZ696 reduces 30-day readmissions for any cause following discharge from HF hospitalization. (C) 2016 by the American College of Cardiology Foundation.

【 授权许可】

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