Study: Sacubitril/Valsartan Cuts Heart Failure Readmissions

Treatment with sacubitril/valsartan (LCZ696) decreases the number of patients with heart failure (HF) who are readmitted to the hospital, according to a new study.

Noting that patients with HF are at high risk for hospital readmission in the first 30 days following HF hospitalization, the study authors sought to determine if treatment with sacubitril/valsartan reduces rates of hospital readmission at 30 days following HF hospitalization compared with enalapril.
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To do so, the researchers assessed the risk of 30-day readmission for any cause following investigator-reported hospitalizations for HF in the PARADIGM-HF trial, which randomized 8399 participants with HF and reduced ejection fraction to treatment with sacubitril/valsartan or enalapril.

Accounting for multiple hospitalizations per patient, there were 2383 investigator-reported HF hospitalizations, of which 1076 (45.2%) occurred in subjects assigned to sacubitril/valsartan and 1307 (54.8%) occurred in subjects assigned to enalapril. Rates of readmission for any cause at 30 days were 17.8% in sacubitril/valsartan-assigned subjects and 21.0% in enalapril-assigned subjects.

Rates of readmission for HF at 30 days were also lower in subjects assigned to sacubitril/valsartan (9.7% vs 13.4%). The reduction in both all-cause and HF readmissions with sacubitril/valsartan was maintained when the time window from discharge was extended to 60 days, and in sensitivity analyses restricted to adjudicated HF hospitalizations.

The authors caution that future studies should seek to clarify the mechanism by which composite angiotensin receptor-neprilysin inhibition exerts benefit beyond the acute hospital phase of treatment compared with angiotensin-converting enzyme inhibition alone in patients with progressive HF and reduced ejection fraction.

Ultimately, however, the investigators concluded that, "compared with enalapril, treatment with LCZ696 reduces 30-day readmissions for any cause following discharge from HF hospitalization."

—Mark McGraw

Reference

Desai AS, Claggett BL, Packer M, et al. Influence of sacubitril/valsartan (LCZ696) on 30-day readmission after heart failure hospitalization. J Am Coll Cardiol. 2016;68(3):241-248.