Author + information
Background: LCZ696 has been proven to reduce adverse clinical outcomes when compared to enalapril in patients with heart failure (HF). Potential clinical use of LCZ696 in real life clinical practice is uncertain. TREAT HF data were analyzed for potential use of LCZ696 in HF patients in real life based on PARADIGM HF, 2016 ESC and ACC/AHA/HFSA HF guidelines criteria.
Methods: TREAT HF is a network designed to evaluate HF patients’ characteristics and treatment modalities. 835 patients with HF and EF ≤40% were included in this analysis. 691 patients (82.7%) were receiving beta blocker, 611 (73.1%)- ACEi or ARB and 537 (64.3%) were receiving both of them. Patients with NYHA II-IV, EF ≤40% and receiving ACEI (or ARB) and beta blocker were considered eligible for LCZ696 based on the basic PARADIGM HF criteria. Also further analysis has been done based on 2016 ACC/AHA/HFSA Focused Update criteria (NYHA II-III, EF ≤40% and receiving ACEI or ARB and beta blocker) and 2016 ESC HF Guidelines criteria (NYHA II-IV, EF ≤35% and receiving ACEI or ARB, beta blocker and aldosterone antagonist).
Results: Patients candidate for LCZ696 based on the basic PARADIGM HF criteria was 55.7% (n=465). In patients with natriuretic peptide (NP) levels (n=322), 41.3% (n=133) met the basic PARADIGM HF and NP criteria. According to 2016 ACC/AHA/HFSA criteria, 54.3% (n=453) were eligible for LCZ696 and in patients with NP levels, 38.5% (n=124) met the 2016 ACC/AHA/HFSA Focused Update and NP criteria. According to 2016 ESC HF Guidelines criteria, 25.7% (n=214) were eligible for LCZ696 and in patients who have data on NP levels, 19.5% (n=63) met the 2016 ESC HF Guidelines and NP criteria. Of those eligible for LCZ696 based on the basic PARADIGM HF criteria, 53.3% (n=248) were in NYHA class II, 44.1% (n=205)- in NYHA class III and only 2.6% (n=12)-in NYHA class IV (p=0.0001).
Conclusions: TREAT HF data suggested that in real life clinical practice, almost 55% of patients would be candidate for LCZ696 based on basic PARADIGM HF or 2016 ACC/AHA/HFSA criteria, whereas only 25% were candidate according to 2016 ESC criteria. These rates further decrease with NP criteria and majority of patients (97%) eligible for LCZ696 were in NYHA II or III functional class.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure and Cardiomyopathies: Heart Failure Is Just a Revolving Door
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1293-253
- 2017 American College of Cardiology Foundation