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Clinical evidence of initiating a very low dose of sacubitril/valsartan: a prospective observational analysis

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dc.contributor.author강석민-
dc.contributor.author박성하-
dc.contributor.author오재원-
dc.contributor.author윤민재-
dc.contributor.author이상학-
dc.contributor.author이상협-
dc.contributor.author이찬주-
dc.contributor.author전경현-
dc.contributor.author강석민-
dc.contributor.author박성하-
dc.contributor.author오재원-
dc.contributor.author윤민재-
dc.contributor.author이상학-
dc.contributor.author이상협-
dc.contributor.author이찬주-
dc.contributor.author전경현-
dc.contributor.author김효은-
dc.date.accessioned2021-12-28T16:58:22Z-
dc.date.available2021-12-28T16:58:22Z-
dc.date.issued2021-08-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/186876-
dc.description.abstractSacubitril/valsartan is superior to enalapril in reducing the risks of cardiovascular death and preventing hospitalization in patients with heart failure and reduced ejection fraction (HFrEF). However, patients often do not receive sacubitril/valsartan because of concerns about hypotension. We examined the feasibility of initiating sacubitril/valsartan at a very low dose (VLD) in potentially intolerant patients with HFrEF and subsequent dose up-titration, treatment persistence and outcomes. We analyzed 206 patients with HFrEF grouped according to starting sacubitril/valsartan dose. The VLD group (n = 106) commenced 25 mg twice daily, and the standard-dose (SD) group (n = 100) started on ≥ 50 mg twice daily. Baseline systolic blood pressure was 103 ± 12 mmHg vs. 119 ± 14 mmHg in the SD group (P < 0.001). The maximal target dose achievement rate was higher in the SD group (27.0% vs 9.4%, p = 0.001) and the VLD group experienced more dose up-titrations and fewer down-titrations than the SD group. The VLD group had a decrease in N-terminal prohormone of brain natriuretic peptide (NT-proBNP) similar to the SD group and a similar increase in left ventricular ejection fraction. There were no significant differences in symptomatic hypotension, worsening renal function, hyperkalemia, cardiovascular mortality, and rehospitalization due to HF between the two groups during follow-up period. In patients considered by the treating physician likely to be intolerant of sacubitril/valsartan, initiation with 25 mg twice daily was generally possible and patients remained in therapy, with similar decreases in NT-proBNP and increases in left ventricular ejection fraction to those observed in patients receiving SD sacubitril/valsartan.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.languageEnglish-
dc.publisherNature Publishing Group-
dc.relation.isPartOfSCIENTIFIC REPORTS-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAminobutyrates / administration & dosage*-
dc.subject.MESHAngiotensin Receptor Antagonists / administration & dosage*-
dc.subject.MESHBiphenyl Compounds / administration & dosage*-
dc.subject.MESHDrug Combinations-
dc.subject.MESHEnalapril / therapeutic use-
dc.subject.MESHFemale-
dc.subject.MESHHeart Failure / drug therapy*-
dc.subject.MESHHeart Failure / metabolism-
dc.subject.MESHHospitalization-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHNatriuretic Peptide, Brain / metabolism-
dc.subject.MESHProspective Studies-
dc.subject.MESHStroke Volume / drug effects-
dc.subject.MESHValsartan / administration & dosage*-
dc.subject.MESHValsartan / therapeutic use-
dc.subject.MESHVentricular Function, Left / drug effects-
dc.titleClinical evidence of initiating a very low dose of sacubitril/valsartan: a prospective observational analysis-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorHyoeun Kim-
dc.contributor.googleauthorJaewon Oh-
dc.contributor.googleauthorSanghyup Lee-
dc.contributor.googleauthorJaehyung Ha-
dc.contributor.googleauthorMinjae Yoon-
dc.contributor.googleauthorKyeong-Hyeon Chun-
dc.contributor.googleauthorChan Joo Lee-
dc.contributor.googleauthorSungha Park-
dc.contributor.googleauthorSang-Hak Lee-
dc.contributor.googleauthorSeok-Min Kang-
dc.identifier.doi10.1038/s41598-021-95787-w-
dc.contributor.localIdA00037-
dc.contributor.localIdA01512-
dc.contributor.localIdA02395-
dc.contributor.localIdA06052-
dc.contributor.localIdA02833-
dc.contributor.localIdA06152-
dc.contributor.localIdA03238-
dc.contributor.localIdA03500-
dc.contributor.localIdA00037-
dc.contributor.localIdA01512-
dc.contributor.localIdA02395-
dc.contributor.localIdA06052-
dc.contributor.localIdA02833-
dc.contributor.localIdA06152-
dc.contributor.localIdA03238-
dc.contributor.localIdA03500-
dc.relation.journalcodeJ02646-
dc.identifier.eissn2045-2322-
dc.identifier.pmid34381126-
dc.contributor.alternativeNameKang, Seok Min-
dc.contributor.affiliatedAuthor강석민-
dc.contributor.affiliatedAuthor박성하-
dc.contributor.affiliatedAuthor오재원-
dc.contributor.affiliatedAuthor윤민재-
dc.contributor.affiliatedAuthor이상학-
dc.contributor.affiliatedAuthor이상협-
dc.contributor.affiliatedAuthor이찬주-
dc.contributor.affiliatedAuthor전경현-
dc.contributor.affiliatedAuthor강석민-
dc.contributor.affiliatedAuthor박성하-
dc.contributor.affiliatedAuthor오재원-
dc.contributor.affiliatedAuthor윤민재-
dc.contributor.affiliatedAuthor이상학-
dc.contributor.affiliatedAuthor이상협-
dc.contributor.affiliatedAuthor이찬주-
dc.contributor.affiliatedAuthor전경현-
dc.citation.volume11-
dc.citation.number1-
dc.citation.startPage16335-
dc.identifier.bibliographicCitationSCIENTIFIC REPORTS, Vol.11(1) : 16335, 2021-08-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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