Renal function dynamics following co-administration of sacubitril/valsartan and empagliflozin in patients with heart failure and type 2 diabetes
De la Espriella, Rafael (Universitat de València)
Bayés-Genís, Antoni (Universitat Autònoma de Barcelona. Departament de Medicina)
Morillas, Herminio (National Cancer Center Hospital East (Japan))
Bravo, Rafael (Hospital Costa del Sol (Marbella))
Vidal, Verónica (Hospital General Universitario de Valencia)
Núñez, Eduardo (Universitat de València)
Santas, Enrique (Universitat de València)
Miñana, Gema (Universitat de València)
Sanchis, Juan (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Facila Rubio, Lorenzo (Hospital General Universitario de Valencia)
Torres, Francisco (National Cancer Center Hospital East (Japan))
Górriz, Jose Luis (Universitat de València)
Valle, Alfonso (National Cancer Center Hospital East (Japan))
Núñez, Julio (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)

Data:	2020
Resum:	The aim of this study was to evaluate the safety profile in terms of changes in renal function after co-treatment with sacubitril/valsartan and empagliflozin in patients with type 2 diabetes (T2D) and heart failure with reduced ejection fraction (HFrEF). This multicentre observational analysis included 108 patients with T2D and HFrEF treated with both agents: baseline sacubitril/valsartan (Group A; n = 43), baseline empagliflozin (Group B; n = 42), or both agents initiated simultaneously (Group C; n = 23). The primary endpoint was estimated glomerular filtration rate (eGFR) dynamics across treatment groups. A binary characterization of worsening renal function (WRF)/improved renal function (IRF) was included in the primary endpoint. WRF and IRF were defined as an increase/decrease in serum creatinine ≥ 0. 3 mg/dL or GFR ≥ 20%. Changes in quantitative variables were evaluated using joint modelling of survival and longitudinal data (JM). Rates and their treatment differences were determined by Poisson regression. The mean left ventricle ejection fraction and eGFR were 32 ± 6% and 70 ± 28 mL/min/1. 73 m 2, respectively. At a median follow-up of 1. 01 years (inter-quartile range 0. 71-1. 50), 377 outpatient visits were recorded. Although there were differences in GFR trajectories over time within each treatment, they did not achieve statistical significance (omnibus P = 0. 154). However, when these differences were contrasted among groups, there was a significant decrease in GFR in Group A as compared with Group B (P = 0. 002). The contrast between Groups C and B was not significant (P = 0. 430). These differences were also reflected when the rates for WRF and IRF were contrasted among treatments. The co-administration of sacubitril/valsartan and empagliflozin in patients with HFrEF and concomitant T2D appears to be safe in terms of renal function.
Ajuts:	Instituto de Salud Carlos III CIBERCV-16-11-00420 Instituto de Salud Carlos III CIBERCV-16-11-00403
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Heart failure with reduced ejection fraction (HFrEF) ; Type 2 diabetes mellitus ; Sacubitril/valsartan ; SGLT2i ; Renal function ; Renal safety profile
Publicat a:	ESC Heart Failure, Vol. 7 (september 2020) , p. 3792-3800, ISSN 2055-5822

DOI: 10.1002/ehf2.12965
PMID: 32964683

9 p, 3.3 MB

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