Long-term effects of angiotensin receptor neprilysin inhibitor therapy in heart failure patients with reduced ejection fraction: A retrospective cohort study

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dc.authoridKoçak, Ajar/0000-0002-4262-7157
dc.authorwosidEkici, Berkay/GXV-9750-2022
dc.authorwosidKoçak, Ajar/AAE-4606-2022
dc.contributor.authorKocak, Ajar
dc.contributor.authorAydin, Saadet
dc.contributor.authorAlibasic, Hayrudin
dc.contributor.authorCicek, Melis
dc.contributor.authorEkici, Berkay
dc.date.accessioned2024-03-09T18:48:31Z
dc.date.available2024-03-09T18:48:31Z
dc.date.issued2023
dc.departmentİzmir Bakırçay Üniversitesien_US
dc.description.abstractHeart 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.en_US
dc.identifier.doi10.1097/MD.0000000000035589
dc.identifier.issn0025-7974
dc.identifier.issn1536-5964
dc.identifier.issue43en_US
dc.identifier.pmid37904474en_US
dc.identifier.scopus2-s2.0-85175694513en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.urihttps://doi.org/10.1097/MD.0000000000035589
dc.identifier.urihttps://hdl.handle.net/20.500.14034/1365
dc.identifier.volume102en_US
dc.identifier.wosWOS:001124112800069en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofMedicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAngiotensin Receptor Neprilysin Inhibitor; Heart Failure With Reduced Ejection Fraction; Sacubitril/Valsartanen_US
dc.titleLong-term effects of angiotensin receptor neprilysin inhibitor therapy in heart failure patients with reduced ejection fraction: A retrospective cohort studyen_US
dc.typeArticleen_US

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