Heart failure & cardiomyopathies
The Impact of Sacubitril/Valsartan on Outcome in Patients Suffering from Heart Failure with a Concomitant Diabetes Mellitus
Authors' conclusion
Sacubitril/valsartan reverses cardiac remodelling in non-diabetes patients. However, it reduces the congestion rate in diabetes and non-diabetes patients. The rates of ventricular tachyarrhythmias were similar in DM compared with non-DM over follow-up.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) treated with sacubitril/valsartan, 2016–2020
- Participants
- 240 patients
- Exposure
- Sacubitril/valsartan in HFrEF with DM vs without DM
- DMn = 87
- No DMn = 153reference
- Outcome
- Life-threatening arrhythmias, AF, echocardiography parameters and congestion rate
- Follow-up
- 24 months
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
| Group | Value | Baseline LVEF | P (change) |
|---|---|---|---|
| No DM | median 35% (IQR 13–64) | 27% IQR [3-44] | P < 0.001 |
| DM | median 30% (IQR 13–55) | 29% IQR [10-65] | P = 0.11 |
Value
Baseline LVEF
P (change)
Observational data: associations, not effects.
Further findings
Congestion rate (before vs after 24 months)
Before
P DM P = 0.0009 · No DM P = 0.0004
All-cause mortality · 24 months
P < 0.01
Troponin-I (baseline to follow-up) · 24 months
Baseline DM 0.05 ng/mL IQR [0.013-103.0] · No DM 0.099 ng/mL IQR [0.009-138.69]
P DM P = 0.27 · No DM P < 0.001
TAPSE (baseline to follow-up) · 24 months
Baseline DM 17.5 mm IQR [8-30] · No DM 17 mm IQR [3-31]
P DM P = 0.70 · No DM P = 0.04
| Outcome | DM | No DM |
|---|---|---|
| NT-proBNP (baseline to follow-up) · 24 months | 885 (IQR 159–4331) pg/mL | median 491 (IQR 13–4571) pg/mL |
| Baseline | 1395 pg/mL IQR [100-29 924] | 1445 pg/mL IQR [12.6-74 676] |
| P | P = 0.06 | P < 0.001 |
eGFR, potassium, creatinine; LA/RA area, E/A ratio; systolic pulmonary artery pressure
- No significant change in DM or non-DM
Original publication
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