Clinical Outcomes of Sacubitril/Valsartan in Elderly Patients with Heart Failure: A Systematic Review
Keywords:
Clinical outcomes, Sacubitril/valsartan, Elderly, Heart Failure, Efficacy and safety, systematic reviewAbstract
Background: Heart failure is one of the leading causes of hospitalization and mortality in elderly patients. In 2015, sacubitril/valsartan, an angiotensin receptor neprilysin inhibitor (ARNI), was approved for the treatment of heart failure.
Objectives: Describing the clinical outcomes of sacubitril/valsartan in elderly patients with heart failure.
Methods: The study employed a systematic review design, presented in the participant-intervention-comparison-outcome (PICO) framework. This method was used to have a thorough summary of all research evidence relevant to the clinical outcomes of sacubitril/valsartan in elderly patients with heart failure.
Results: A total of 210 studies were screened from three scientific databases: PubMed (n=44), ScienceDirect (n=113), and Google Scholar (n=53). After the screening, a total of 32 studies were included for the clinical outcomes of sacubitril/valsartan in elderly patients with heart failure, and a total of 7 studies were included for the assessment of the efficacy and safety of sacubitril/valsartan in the treatment of heart failure in elderly patients. Clinical outcomes categorized the results of sacubitril/valsartan. These categories include reduced rehospitalization and mortality, reversal of cardiac remodeling, improvement in biomarkers and cardiac parameters, enhanced NYHA classification and quality of life, improved heart function, and others. Furthermore, the efficacy and safety of sacubitril/valsartan were also assessed and described in this review.
Conclusion: This systematic review indicates that sacubitril/valsartan reduces rehospitalization and mortality, reverses cardiac remodeling, improves biomarkers and cardiac parameters, enhances NYHA classification and quality of life, enhances heart function, and yields other miscellaneous clinical benefits. Moreover, sacubitril/valsartan is effective in reducing blood pressure in elderly patients with systolic hypertension, mortality, rehospitalization, and reducing the NYHA classification of patients. Therefore, sacubitril/valsartan was found to be well tolerated in elderly patients with heart failure. In patients with HFrEF, treatment with sacubitril/valsartan has been demonstrated to significantly reduce mortality and the rates of hospitalization and rehospitalization for HF when compared to enalapril.
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