Impact of sacubitril/valsartan on atrial fibrillation burden in heart failure: a retrospective observational study.

Background: Sacubitril/valsartan (an angiotensin receptor‐neprilysin inhibitors [ARNI]) might improve atrial fibrillation (AF) condition, but its added value remains controversial. Aim: We aimed to analyse the effect of ARNI on AF burden. Method: We conducted a single‐centre, retrospective self‐cont...

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Publicado en:Journal of Pharmacy Practice & Research Vol. 55; no. 1; pp. 53 - 61
Autores principales: Barradas, Ana, de Almeida Fernandes, Diogo, Fonseca, Inês, António, Natália, Elvas, Luís, Gonçalves, Lino
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Feb2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2025
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1002/jppr.1942
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        atl: Impact of sacubitril/valsartan on atrial fibrillation burden in heart failure: a retrospective observational study.
      aug:
        au:
          Barradas, Ana
          de Almeida Fernandes, Diogo
          Fonseca, Inês
          António, Natália
          Elvas, Luís
          Gonçalves, Lino
        affil: Faculty of Medicine, University of Coimbra, Coimbra, Portugal
      sug:
        subj:
          Aminobutyric Acids Therapeutic Use
          Valsartan Therapeutic Use
          Atrial Fibrillation Drug Therapy
          Heart Failure
          Angiotensin II Type I Receptor Blockers Therapeutic Use
          Enzyme Inhibitors Therapeutic Use
          Human
          Retrospective Design
          Nonexperimental Studies
          Tertiary Health Care
          Record Review
          Scales
          Descriptive Statistics
          Male
          Female
          Male
          Female
      ab: Background: Sacubitril/valsartan (an angiotensin receptor‐neprilysin inhibitors [ARNI]) might improve atrial fibrillation (AF) condition, but its added value remains controversial. Aim: We aimed to analyse the effect of ARNI on AF burden. Method: We conducted a single‐centre, retrospective self‐controlled study in a tertiary centre. Data were retrieved from January 2019–January 2023. All cardiac resynchronisation therapy‐implantable cardioverter defibrillator (CRT‐D) carriers on ARNI were included if implantation had been at least 3 months before drug initiation. Proarrhythmic events, equal time length control (before ARNI initiation), and exposure (after ARNI initiation) periods were defined. Echocardiographic data were retrieved if they were up to 1 year old before ARNI initiation and if they were available 3 months to 1 year after initiation. AF burden was defined by frequency and median value of paroxysmal events and the overall variation in AF status was determined. Ethical approval was granted by the Ethics Committee of the Centro Hospitalar e Universitário de Coimbra (Reference no: PI OBS.SF.174‐2022) and the study conforms with the Declaration of Helsinki. Results: Seventy‐two patients were included in the study (73.3% men). After ARNI, there was a reduction in New York Heart Association functional class ± standard deviation (2.00 ± 0.75 to 1.85 ± 0.61, p = 0.043) and an increase in left ventricular ejection fraction ± standard deviation (from 31.67% ± 9.28% vs 37.33% ± 14.49%, p = 0.027). Before ARNI initiation, 34 patients did not have AF, 19 had paroxysmal AF, 15 had permanent AF, and 2 had persistent AF. The total amount of AF episodes (91 vs 44, p = 0.808) and median paroxysmal episodes (among those with paroxysmal AF or no AF) (5 vs 3, p = 0.121) were numerically reduced after ARNI initiation, though variation was not statistically significant. No differences were found as well regarding ventricular arrhythmias or device therapies. Conclusion: ARNI did not significantly decrease the number of AF paroxysmal episodes or median number of paroxysmal events per patient. Even though ARNI may have a positive impact on AF burden of heart failure patients, larger studies are needed to provide unequivocal evidence.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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