![Large peridevice leaks after left atrial appendage occlusion (LAAO) are incredibly rare and not associated with a greater risk of adverse outcomes, according to new research published in JACC: Clinical Electrophysiology.[1] Smaller residual links are more common, however, and associated with a risk of thromboembolic and bleeding events.](/sites/default/files/styles/top_stories/public/2018-08/olderpatient-doctor.jpg.webp?itok=Cv18wcDr)
Sacubitril/valsartan does not appear to be a better treatment option for advanced heart failure (HF) than valsartan on its own, according to a new study published in JAMA Cardiology.
Researchers examined 335 patients with advanced HF from the LIFE trial. Patients were treated from March 2017 to March 2020. Seventy-three-percent of the patients were men, and the mean age was 59 years old.
The team's goal was to evaluate the efficacy, safety, and tolerability of the sacubitril/valsartan combination in patients with advanced chronic HF and a reduced ejection fraction. Patients were randomized to receive either sacubitril/valsartan or valsartan on top of their recommended therapy.
Of the eligible patients, 18% were not able to tolerate sacubitril/valsartan during the short run-in period. Also, 29% stopped taking sacubitril/valsartan during the 24 weeks of the trial.
Data from the study showed no difference between sacubitril/valsartan and valsartan with regards to lowering baseline NT-proBNP levels in patients with advanced HF.
In addition, the secondary endpoint that focused on the number of patient days alive, days out of hospital and days without HF episodes was better in the valsartan arm than the sacubitril/valsartan arm.
“This finding was consistent across most subgroups examined,” wrote lead author Douglas L. Mann, MD, with the department of medicine at Washington University School of Medicine in St Louis,
“The findings of the trial were really surprising to us,” lead author Douglas L. Mann, MD, a cardiologist and professor at Washington University School of Medicine in St Louis, said in a prepared statement. “In every other trial involving sacubitril/valsartan, the drug showed a benefit over the standard of care, including lowering NT-proBNP levels. Even though we didn’t have a large enough sample size in the trial to see clinically meaningful differences in the endpoints between the two groups, every clinical outcome that we measured favored treatment with valsartan alone."
Read the full study here.