Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
ISSN: 2155-9880
Felix Nunura, Edwin Tulloch-Reid, Daniel Nepaul, Dainia S Baugh and Ernest C Madu
Background: The guidelines have recommended Sacubitril/Valsartan as a substitute to Angiotensin Converting Enzyme Inhibitors (ACEIs), to further reduce the risk of hospitalization and death in ambulatory patients with Heart Failure with reduced Ejection Fraction (HFrEF). However, extensive real-world evidence for its tolerance, safety and efficacy in Blacks, has been lacking. We present additional data on real world about the use of Sacubitril/Valsartan in the unique Afro-Caribbean population with HFrEF.
Methods: A cohort of 44 patients (Age 58 ± 1.91 years-old, 61.36% Male, Hypertensive 72.7, Diabetic 25%, Ischemic Cardiomyopathy 47.7)) with HFrEF (LVEF: 27.37 ± 1.19) seen at the Heart Institute of the Caribbean in Jamaica between August 2017 and September 2018 was examined. Clinical Data, heart failure features and the frequency of Prospectively Identified Adverse Events (PIAE) were extracted from Electronic Medical Records. Patients were prescribed Sacubitril/Valsartan following the manufacturer recommendations. Echocardiographic Ejection Fraction (EF) at baseline and post intervention was analyzed. Wilcoxon signed-rank test and paired sample t-test were used to compare these features before and after treatment.
Results: The most frequent PIAE were symptomatic hypotension 13.63%, cough 6.81% and renal dysfunction 2.27%. None of the treated patients developed angioedema. Post-treatment echocardiograms of 28 patients, demonstrated an average of 14.6% (SE=1.8%) increase in EF, from 28.92% to 43.81% (p<0.0001) over a median of 5.59 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.