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6ER-005 Use of sacubitril/valsartan in patients with chronic heart failure
  1. L Enríquez Olivar1,
  2. AM López González2,
  3. S Izquierdo Muñoz2,
  4. E Queipo García2,
  5. MT Sánchez Sánchez2
  1. 1Hospital Clínico Universitario, Hospital Pharmacy, Valladolid, Spain
  2. 2Hospital Clínico Universitario de Valladolid, Hospital Pharmacy, Valladolid, Spain


Background Recommendations approved by the local Pharmacy and Therapeutics Committee (PTC) for the prescription of Sacubitril/Valsartan (SV) are: patients with chronic symptomatic heart failure (HF) (II–III grade following New York Association (NYHA)) with reduced left ejection fraction (LVEF <35%) and elevated N-terminal Pro B-type natriuretic peptide (NT-proBNP >640 pg/ml) seric levels to be treated with standard of care therapy: angiotensin converting enzyme inhibitors (ACE) or angiotensin II receptor blockers (ARB), in combination with beta-blockers (BB) and mineralcorticoid antagonists.

Purpose To evaluate the adherence to the recommendations of the PTC concerning the prescriptions of SV on hospital admission.

Material and methods A descriptive, observational and prospective study including patients treated with SV from March 2018 to July 2018 in a General Teaching Hospital.

Variables considered were: sex, age, patient chronic and fragile (G3), according to the stratification of the regional Health Service, HF NYHA classification, LVEF, NT-proBNP, previous treatment with ACE inhibitors/ARBs, BB and mineralcorticoid antagonists at hospital admission and glomerular filtration rate (GFR).

Results Fifty-one patients were included: 84% (43/51) were men, average 69±11 years and 51% (30/51) were G3.

According to the PTC’s recommendations: 26/51 (51%) patients with NYHA III and 20% (10/51) NYHA II grade. The median of NT-proBNP was of 2,396 pg/ml (247–49, 280), 31/51 (61%) patients had NT-proBNP levels registered in the electronic clinical record (ECR), 3/31 (10%) patients had NT-proBNP <640 pg/ml: the average of LVEF was 31%±8%, 39/51 (76%) patients had LVEF levels registered in ERC, 8/51 (16%) patients had LVEF >35%. Ninety per cent of patients received ACE or ARB and 57% (29/51) received both BB and mineralcorticoid antagonists. Just 27/51 (53%) of patients were well-treated with standard care therapy (ACE/ARBs, BB and mineralcorticoid antagonists). Two per cent (1/51) of patients had GFR <30 ml/min. After the study period, 82% (42/51) of patients continued treatment with SV and patients were followed by primary care physicians.

Conclusion The results show a low adherence of prescriptions with SV according to the PTC’s recommendations. The recording of the variables NT-proBNP and LVEF in the ECR could be improved.

References and/or acknowledgements

No conflict of interest.

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