Outcomes with sacubitril/valsartan in outpatients with heart failure and reduced ejection fraction: The ARIADNE registry

Abstract Aims ARIADNE aimed to assess the association between effects of sacubitril/valsartan and no sacubitril/valsartan treatment and clinical characteristics, functional capacity, and clinical outcomes (cause‐specific mortality and hospitalizations) in outpatients with heart failure (HF) with red...

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Main Authors: Aldo P. Maggioni, Andrew L. Clark, Vivencio Barrios, Thibaud Damy, Jaroslaw Drozdz, Candida Fonseca, Lars H. Lund, Stefanie Kalus, Philippe C. Ferber, Rizwan I. Hussain, Cornelia Koch, Uwe Zeymer, the ARIADNE investigators
Format: Article
Language:English
Published: Wiley 2022-12-01
Series:ESC Heart Failure
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Online Access:https://doi.org/10.1002/ehf2.14014
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author Aldo P. Maggioni
Andrew L. Clark
Vivencio Barrios
Thibaud Damy
Jaroslaw Drozdz
Candida Fonseca
Lars H. Lund
Stefanie Kalus
Philippe C. Ferber
Rizwan I. Hussain
Cornelia Koch
Uwe Zeymer
the ARIADNE investigators
author_facet Aldo P. Maggioni
Andrew L. Clark
Vivencio Barrios
Thibaud Damy
Jaroslaw Drozdz
Candida Fonseca
Lars H. Lund
Stefanie Kalus
Philippe C. Ferber
Rizwan I. Hussain
Cornelia Koch
Uwe Zeymer
the ARIADNE investigators
author_sort Aldo P. Maggioni
collection DOAJ
description Abstract Aims ARIADNE aimed to assess the association between effects of sacubitril/valsartan and no sacubitril/valsartan treatment and clinical characteristics, functional capacity, and clinical outcomes (cause‐specific mortality and hospitalizations) in outpatients with heart failure (HF) with reduced ejection fraction (HFrEF). Methods ARIADNE was a prospective European registry of 9069 patients with HFrEF treated by office‐based cardiologists or selected primary care physicians. Of the 8787 eligible for analysis, 4173 patients were on conventional HF treatment (non‐S/V group), whereas 4614 patients were either on sacubitril/valsartan treatment at enrolment or started sacubitril/valsartan within 1 month of enrolment (S/V group). We also generated a restricted analysis set (rS/V) including only those 2108 patients who started sacubitril/valsartan treatment within the month prior to or after enrolment. Results At the baseline, average age of patients enrolled in the study was 68 years, and 23.9% (2099/8787) were female. At the baseline, the proportions of patients with New York Heart Association (NYHA) Class III symptoms were 30.9 (1288/4173), 42.8 (1974/4614), and 48.2% (1015/2108), in non‐S/V, S/V, and rS/V groups, respectively. After 12 months of treatment, the proportion of patients with NYHA Class III at baseline who improved to Class II was 32.0% (290/907) in the non‐S/V group vs. 46.3% (648/1399) in S/V group and 48.7% (349/717) in rS/V group. The overall mortality rate was 5.0 per 100 patient‐years. Rates of HF hospitalizations were high (20.9, 20.3, and 21.2 per 100 patient‐years in the non‐S/V, S/V, and rS/V groups, respectively). Emergency room visits without hospitalization occurred in 3.9, 3.2, and 3.9% of patients in the non‐S/V, S/V, and rS/V groups, respectively. Conclusions This large HFrEF European registry provides a contemporary outcome profile of outpatients with HFrEF treated with or without sacubitril/valsartan. In a real‐world setting, sacubitril/valsartan was associated with an improvement of symptoms in patients with HFrEF compared with the conventional HFrEF treatment.
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spelling doaj.art-1e95d61631394164bb9aeae759fd023a2022-12-22T12:55:34ZengWileyESC Heart Failure2055-58222022-12-01964209421810.1002/ehf2.14014Outcomes with sacubitril/valsartan in outpatients with heart failure and reduced ejection fraction: The ARIADNE registryAldo P. Maggioni0Andrew L. Clark1Vivencio Barrios2Thibaud Damy3Jaroslaw Drozdz4Candida Fonseca5Lars H. Lund6Stefanie Kalus7Philippe C. Ferber8Rizwan I. Hussain9Cornelia Koch10Uwe Zeymer11the ARIADNE investigatorsHeart Care Foundation ANMCO Research Centre Florence ItalyHull University Teaching Hospitals NHS Trust Hull UKUniversity Hospital Ramon y Cajal Madrid SpainUniversity Hospital Henri Mondor Créteil FranceMedical University of Lodz Lodz PolandHospital de Sao Francisco Xavier, Lisbon, NOVA Medical School, Faculdade de Ciências Médicas Universidade Nova de Lisboa Lisbon PortugalDepartment of Medicine Karolinska Institutet and Karolinska University Hospital Stockholm SwedenGKM Gesellschaft für Therapieforschung mbH Munich GermanyNovartis Pharma Basel SwitzerlandArxx Therapeutics Oslo NorwayNovartis Pharma Basel SwitzerlandKlinikum Ludwigshafen and Institut für Herzinfarktforschung Ludwigshafen‐am‐Rhein GermanyAbstract Aims ARIADNE aimed to assess the association between effects of sacubitril/valsartan and no sacubitril/valsartan treatment and clinical characteristics, functional capacity, and clinical outcomes (cause‐specific mortality and hospitalizations) in outpatients with heart failure (HF) with reduced ejection fraction (HFrEF). Methods ARIADNE was a prospective European registry of 9069 patients with HFrEF treated by office‐based cardiologists or selected primary care physicians. Of the 8787 eligible for analysis, 4173 patients were on conventional HF treatment (non‐S/V group), whereas 4614 patients were either on sacubitril/valsartan treatment at enrolment or started sacubitril/valsartan within 1 month of enrolment (S/V group). We also generated a restricted analysis set (rS/V) including only those 2108 patients who started sacubitril/valsartan treatment within the month prior to or after enrolment. Results At the baseline, average age of patients enrolled in the study was 68 years, and 23.9% (2099/8787) were female. At the baseline, the proportions of patients with New York Heart Association (NYHA) Class III symptoms were 30.9 (1288/4173), 42.8 (1974/4614), and 48.2% (1015/2108), in non‐S/V, S/V, and rS/V groups, respectively. After 12 months of treatment, the proportion of patients with NYHA Class III at baseline who improved to Class II was 32.0% (290/907) in the non‐S/V group vs. 46.3% (648/1399) in S/V group and 48.7% (349/717) in rS/V group. The overall mortality rate was 5.0 per 100 patient‐years. Rates of HF hospitalizations were high (20.9, 20.3, and 21.2 per 100 patient‐years in the non‐S/V, S/V, and rS/V groups, respectively). Emergency room visits without hospitalization occurred in 3.9, 3.2, and 3.9% of patients in the non‐S/V, S/V, and rS/V groups, respectively. Conclusions This large HFrEF European registry provides a contemporary outcome profile of outpatients with HFrEF treated with or without sacubitril/valsartan. In a real‐world setting, sacubitril/valsartan was associated with an improvement of symptoms in patients with HFrEF compared with the conventional HFrEF treatment.https://doi.org/10.1002/ehf2.14014ARNIHeart failureHeart failure with reduced ejection fractionOutcomesOutpatientsSacubitril/valsartan
spellingShingle Aldo P. Maggioni
Andrew L. Clark
Vivencio Barrios
Thibaud Damy
Jaroslaw Drozdz
Candida Fonseca
Lars H. Lund
Stefanie Kalus
Philippe C. Ferber
Rizwan I. Hussain
Cornelia Koch
Uwe Zeymer
the ARIADNE investigators
Outcomes with sacubitril/valsartan in outpatients with heart failure and reduced ejection fraction: The ARIADNE registry
ESC Heart Failure
ARNI
Heart failure
Heart failure with reduced ejection fraction
Outcomes
Outpatients
Sacubitril/valsartan
title Outcomes with sacubitril/valsartan in outpatients with heart failure and reduced ejection fraction: The ARIADNE registry
title_full Outcomes with sacubitril/valsartan in outpatients with heart failure and reduced ejection fraction: The ARIADNE registry
title_fullStr Outcomes with sacubitril/valsartan in outpatients with heart failure and reduced ejection fraction: The ARIADNE registry
title_full_unstemmed Outcomes with sacubitril/valsartan in outpatients with heart failure and reduced ejection fraction: The ARIADNE registry
title_short Outcomes with sacubitril/valsartan in outpatients with heart failure and reduced ejection fraction: The ARIADNE registry
title_sort outcomes with sacubitril valsartan in outpatients with heart failure and reduced ejection fraction the ariadne registry
topic ARNI
Heart failure
Heart failure with reduced ejection fraction
Outcomes
Outpatients
Sacubitril/valsartan
url https://doi.org/10.1002/ehf2.14014
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