Risk stratification by renal function and NYHA class in patients with hypotension initiated on sacubitril/valsartan: a retrospective cohort study from 17 centres in Japan

作者：Koshiro Kanaoka, Takahito Nasu, Atsushi Kikuchi, Takeshi Ijichi, Tatsuhiro Shibata, Keisuke Kida, Nobuyuki Kagiyama, Wataru Fujimoto, Syunsuke Ishii, Yoshitaka Iwanaga, Yoshihiro Miyamoto, S. Matsumoto · 发表于：Open Heart · 年份：2024 · DOI：10.1136/openhrt-2024-002764 · 被引用次数：3 · 研究领域：Heart Failure Treatment and Management、Blood Pressure and Hypertension Studies、Heart rate and cardiovascular health

Background Patients with heart failure exhibiting low systolic blood pressure (SBP) have a poor prognosis. Sacubitril/valsartan reduces cardiovascular events; however, its use in patients with low SBP has not been fully examined. Therefore, in this study, we aimed to investigate the association between baseline SBP and adverse events (AEs) in patients starting sacubitril/valsartan therapy using data from a real-world registry in Japan. Methods We analysed data from a multicentre retrospective study, including patients who initiated sacubitril/valsartan between August 2020 and August 2021. The patients were categorised into five groups based on their baseline SBP (<100, 100–109, 110–119, 120–129 and ≥130 mm Hg). The composite of AEs occurring within 3 months according to baseline SBP and the patient characteristics associated with AEs in a baseline SBP <110 mm Hg were analysed. Results Among the 964 patients newly prescribed sacubitril/valsartan, the median (IQR) age was 73 (61–80) years, and 388 (40.2%) patients had a baseline SBP <110 mm Hg. AEs occurred in 24% (n=232) of patients. The adjusted ORs for all AEs were 1.91 (95% CI (CI) 1.13–3.23; p=0.02) for the SBP <100 mm Hg group and 3.33 (95% CI 1.98 to 5.59; p<0.001) for the SBP 100–109 mm Hg group, compared with the SBP 110–119 mm Hg group. In patients with a baseline SBP <110 mm Hg, factors associated with an increased risk of AEs included a higher New York Heart Association class (II, III or IV) and a ...