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- Title
Risk Factors for Intolerance of Inpatient Sacubitril/Valsartan Initiation.
- Authors
Akerman, Caitlin C.; Beavers, Janna C.
- Abstract
Background: Sacubitril/valsartan has been shown to improve outcomes in patients with heart failure with reduced ejection fraction (HFrEF). However, initiation of sacubitril/valsartan has primarily been studied in stable, ambulatory patients with HFrEF. Objective: The objective of this study was to determine risk factors for intolerance to inpatient sacubitril/valsartan initiation. Methods: This was a retrospective, single-center study from August 1, 2015 through April 30, 2018. Patients were at least 18 years old and were newly initiated on sacubitril/valsartan during their hospitalization. Results: A total of 143 patients met inclusion criteria. Of these patients, 20.3% (n = 29) were intolerant to inpatient initiation of sacubitril/valsartan. The primary reason for intolerance was hypotension (n = 19, 65.5%). Patients with newly diagnosed heart failure were more likely to tolerate the initiation of sacubitril/valsartan (32.5% vs 10.3%; P = 0.03). No differences between groups were identified among other potential predictors for intolerance to sacubitril/valsartan, including systolic blood pressure, acutely decompensated heart failure, or serum creatinine. The most common adverse event was hypotension, which occurred in 26.6% (n = 38) of all patients. Conclusion: The majority of inpatients tolerated sacubitril/valsartan initiation. Larger, prospective, randomized controlled trials would be helpful in further determining ideal candidates for inpatient sacubitril/valsartan initiation.
- Subjects
ANTIHYPERTENSIVE agents; COMBINATION drug therapy; DRUG tolerance; PSYCHOLOGY of hospital patients; VENTRICULAR ejection fraction; ACQUISITION of data methodology; ANGIOTENSINS; PROTEOLYTIC enzymes; CELL receptors; RETROSPECTIVE studies; RISK assessment; VALSARTAN; MEDICAL records; DESCRIPTIVE statistics; HYPOTENSION; HEART failure; CHEMICAL inhibitors; THERAPEUTICS; DISEASE complications
- Publication
Journal of Pharmacy Practice, 2021, Vol 34, Issue 3, p454
- ISSN
0897-1900
- Publication type
Article
- DOI
10.1177/0897190019878948