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Sacubitril/Valsartan in Heart Failure With Reduced Ejection Fraction 

Low, medium, and high doses of sacubitril/valsartan (Sac/Val) were associated with similar outcomes in patients with heart failure with reduced ejection fraction (HFrEF), researchers report. In the Effects of Sacubitril/Valsartan Therapy on Biomarkers, Myocardial Remodeling and Outcomes (PROVE-HF) study, 794 people with HFrEF were grouped into tertiles based on average daily Sac/Val doses. From baseline to 12 months, outcomes were assessed based on biomarkers, Kansas City Cardiomyopathy Questionnaire-23 scores, and parameters of cardiac reverse remodeling.

“The average daily dose was 112 mg in Tertile 1 (low dose), 342 mg in Tertile 2 (moderate dose), and 379 mg in Tertile 3 (high dose),” the authors report. “Similar changes in prognostic biomarkers were observed in all dose tertiles. Gains in Kansas City Cardiomyopathy Questionnaire-23 scores were comparable regardless of dose category. Consistent reverse cardiac remodeling in all dose categories occurred; the median absolute left ventricular EF improvement across HF dose groups was 9.3%, 8.7%, and 10.2%, for low, moderate, and high doses, respectively; similar improvements in left atrial and ventricular volumes and E/e’ were also observed across dose categories.”