Effects of sacubitril/valsartan dose on sociodemographic and clinical predictor variables: an Irish cross-sectional study

Background: The syndrome of heart failure is a recognised epidemic affecting between 1% and 2% of adults in the developed world. Several landmark clinical trials have led to improvements in heart-failure management over the past two decades. Aims: To examine the association between sociodemographic and clinical variables and change in ejection fraction, and whether age affected improvement in ejection fraction, New York Heart Association classification and estimated glomerular filtration rate following higher doses of sacubitril/valsartan. Methods: In this cross-sectional Irish study, descriptive and inferential statistical analyses were used. Results: Post-sacubitril/valsartan ejection fraction measurements were taken on 162 people, as well as 198 measures for both New York Heart Association classification and estimated glomerular filtration rate post sacubitril/valsartan. With a dose of 97 mg/103 mg, twice daily, patients had 7.70 (2.812-21.078) times higher odds of improvement in ejection fraction than those who received the lower dose of 24 mg/26 mg twice daily. Irrespective of drug dose administered, patients aged under 65 years have a greater improvement in ejection fraction, relative to those aged over 65 years. Patients with myocardial infarction history had lower odds of ejection-fraction improvement than those with no myocardial infarction history. There was no association between age and improvement in New York Heart Association classification or estimated glomerular filtration rate. Conclusion: Sacubitril/valsartan is effective in improving ejection fraction. This improvement is greater among patients under 65 years of age. Higher dosages lead to higher odds of improvement, when adjusted for age and history of myocardial infarction.