Sacubitril/valsartan reduced 30-day hospital readmissions from any cause following discharge from heart failure hospitalization, according to data recently published in the Journal of the American College of Cardiology.

Akshay Desai, MD, MPH, of the Cardiovascular Division at Brigham and Women’s Hospital in Boston, and colleagues assessed the 30-day risk of readmission from any cause using heart failure hospitalizations from the PARADIGM-HF trial (Prospective Comparison of ARNI with an ACE-Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure).

The trial included 8399 participants with heart failure and reduced ejection fraction who were randomly assigned to receive either sacubitril/valsartan or enalapril. Researchers of the present study examined 2383 investigator-reported hospitalizations from the trial. Of these hospitalizations, 45.2% occurred in patients assigned to sacubitril/valsartan and 54.8% occurred in patients assigned to enalapril.


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The hospital readmission rate for any cause at 30 days was 17.8% among patients taking sacubitril/valsartan and 21.0% among patients taking enalapril (odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.56-0.97; P=.031). In addition, the readmission rate for heart failure at 30 days was 9.7% among patients who took sacubitril/valsartan and 13.4% among patients who took enalapril (OR: 0.62; 95% CI: 0.45-0.87; P=.006).

“These data highlighting fewer all-cause and heart-failure readmissions at 30 days during treatment with [sacubitril/valsartan] relative to enalapril provide additional rationale for use of sacubitril/valsartan in preference to enalapril in patients with chronic, symptomatic heart failure and reduced ejection fraction,” the authors concluded.

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Researchers noted that the reduction of all-cause and heart failure hospital readmissions with sacubitril/valsartan and enalapril was maintained in sensitivity analyses that were restricted to adjudicated heart failure hospitalizations, and when the time from discharge was extended to 60 days.

“This impact on readmissions after heart failure hospitalization should be viewed in context of the already established 21% reduction in risk of first heart failure hospitalization compared with enalapril, and provides more granular insight into the 23% reduction in cumulative burden of heart failure hospitalization that has previously been reported,” the authors noted.

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. doi: 10.1016/j.jacc.2016.04.047.