Treatment of Heart Failure with Sacubitril/Valsartan in Hondurans with Reduced Left Ventricular Ejection Fraction: A Three-Year Experience

Background: heart failure with reduced ejection fraction (hfref) is a paramountmedical condition affecting more than 23 million individuals worldwide. it is one of theleading causes of morbidity and mortality, particularly in the western world, making it avital topic of discussion in the current clinical trials.objective: this study aimed to describe the response to sacubitril/valsartan in a groupof hondurans with heart failure and reduced left ventricular ejection fraction (lvef)between january 2018 and june 2020.methods: this observational, descriptive, retrospective cohort study was conductedon 105 adult patients with hfref who received treatment with angiotensin-receptorantagonist/neprilysin inhibitors (sacubitril/valsartan) in a single medical center inhonduras. the study participants included the patients with lvef < 40% treated withsacubitril/valsartan for at least one year. the patients also received optimal medicaltherapy for hfref according to the american heart association guidelines. the datawere analyzed using the spss 25.0 software.results: the results showed that the main etiology of hfref was ischemic heartdisease (41%). the lvef changed from a median of 30% to 45% after one year oftreatment. additionally, the overall glomerular filtration rate (gfr) remainedunchanged. however, the n-terminal pro b-type natriuretic peptide (ntprobnp)decreased from a median of 8800 pg/ml to 1900 pg/ml after 12 months.conclusions: the study population had sociodemographic and clinical similaritieswith the latin american cohort in the paradigm-hf trial with the significantimprovement of the lvef and functional class. however, the median level of ntprobnpwas 8800 pg/ml at baseline in the current study, which was dramatically higherthan 1760 pg/ml reported in the paradigm-hf trial, suggesting the need for furtheranalyses in the honduran population.