engleski

Safety of sacubitril-valsartan vs. ramipril in left ventricular assist device carriers and comparison of NTproBNP levels - a pilot study

Background: Currently, there is no consensus on the optimal medical therapy for patients after left ventricular assist device (LVAD) implantation, but usually the HFrEF therapy is continued beyond implant. We compared NT-proBNP values in LVAD patients treated with ramipril or sacubitril/valsartan (sac/val).Patient sand Methods: A single centre, retrospective study included data from 26 patients(88% male, mean age 59±11 years). 54% were continuously treated with ramipril, and 46% were switched to sac/val. The median follow-up was 13.3 months(IQR 8.5-15.4).Results:Baseline patient data are presented in Table 1. Throughout the followup, the mean arterial blood pressure, creatinine and glomerular filtration rate (GFR)values did not change significantly (Figure 1a). A decrease in NT-proBNP values was noted in both groups, although without significant difference between them. However, a difference in trends expressed as negative logarithms of ratios of NT- proBNPat 3 months follow up and at baseline is seen in the sac/val group compared to those on ramipril, achieving significance (p=0.009) for the low medication doses(Figure 1b). During follow-up, 3 patients died in the ramipril subgroup and none in the sac/val group, but the sample size precluded survival analyses.Conclusion: Our data suggest a good safety profile of sac/val in LVAD recipients. A decrease in NT-proBNP values is seen in patients in both treatment groups, with results suggestive of a decrease in the biomarker with sac/val. However, a larger prospective randomized study is required to establish the consistency of this finding and its translation to treatment benefit.

sacubitril-valsartan, left ventricular assist device

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