Category: Federal Forum Posters
Purpose: Angiotensin converting enzyme inhibitors (ACEI) in conjunction with a beta-blocker are recommended to reduce morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF). Angiotensin II receptor blockers (ARB) are recommended in patients intolerant to ACEI. Replacement by sacubitril and valsartan is recommended to further reduce morbidity and mortality in patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACEI or ARB. The purpose of this study is to identify and evaluate patients with HFrEF receiving an ACEI or ARB to determine if they are candidates for therapy with sacubitril and valsartan.
Methods: This study is a retrospective, analysis reviewing computerized data. Data from approximately 100 subjects diagnosed with HFrEF will be collected. Patients included are diagnosed with HFrEF (left ventricle ejection fraction less than or equal to 35 percent), NYHA class II or III, receiving a stable dose of an ACEI or ARB equivalent to at least enalapril 10 mg per day, and receiving a stable dose of a beta-blocker. Exclusion criteria includes current acute decompensated heart failure, hypersensitivity to any component of sacubitril or valsartan, history of angioedema, symptomatic hypotension or systolic blood pressure less than 100 mm Hg, severe renal impairment (estimated glomerular filtration rate less than 30 milliliters per minute), serum potassium greater than 5.2 milliequivalents per liter, severe hepatic impairment (Child-Pugh C), history of intolerance to ARB therapy, concomitant treatment with aliskiren in patients with diabetes, and pregnancy. Patients will be identified and evaluated in reference to recommendations from the 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure and the Veteran Affairs Pharmacy Benefits Management Criteria for Use.
Results: not applicable
Conclusion: not applicable
Jowana Tekle– PGY1 Pharmacy Practice Resident, VA New York Harbor Healthcare System, Brooklyn, NY