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Initial clinical experience with the first drug (sacubitril/valsartan) in a new class -arni- in afro-caribbean patients with heart failure and reduced ejection fraction

Session Poster Session 3

Speaker Felix Nunura

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Pharmacotherapy
  • Session type : Poster Session

Authors : F Nunura (KINGSTON,JM), ETR Tulloch-Reid (KINGSTON,JM), DN Nepaul (KINGSTON,JM), EM Madu (KINGSTON,JM)

Authors:
F Nunura1 , ETR Tulloch-Reid1 , DN Nepaul1 , EM Madu1 , 1HEART INSTITUTE OF THE CARIBBEAN, CARDIOVASCULAR MEDICINE - KINGSTON - Jamaica ,

Citation:

Background: Among Afro-Caribbean patients with heart failure and reduced ejection fraction (HFrEF), non-ischemic dilated cardiomyopathy is the most frequent etiology. There are no studies on the use of the Angiotensin II Receptor Blocker Neprilysin Inhibitor (ARNI), Sacubitril/Valsartan in this population. We present the initial experience concerning the tolerance, safety, adverse effects and efficacy of ARNI among Afro-Caribbean.  Methods: An observational, non-interventional, real-world study was done  based on 44 patients with HFrEF, in Jamaica between October, 2017, and June , 2018. Clinical characteristics, features of heart failure and adverse events (AE) were documented. Eligible patients were prescribed Sacubitril/Valsartan, titrating the dose up to 200 mg twice daily over 4 to 8 weeks. Subsequently, echocardiographic Ejection Fraction (EF) at baseline and post intervention were reviewed. Wilcoxon signed-rank test and paired sample t-test were used to compare groups. Results: The most frequent AE were symptomatic hypotension 11.36%, cough 6.81%, and renal dysfunction 2.27%. None developed angioedema. Post-treatment echocardiograms of 26 patients, demonstrated an average of 14.7% (±2) increase in EF, from 29.4% to 44.1% (p<0.001) over a median of 3.15 months of therapy. Conclusion: Sacubitril/Valsartan was demonstrated to be safe, well tolerated and associated with significant functional improvement among Afro-Caribbean patients with HFrEF.

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