发布日期：2016 年 7 月
英文标题：
Influence of Sacubitril/Valsartan (LCZ696) on 30-Day Readmission After Heart Failure Hospitalization.
作者：
Desai AS, Claggett BL, Packer M, Zile MR, Rouleau JL, Swedberg K, Shi V, Lefkowitz M, Starling R, Teerlink J, McMurray JJ, Solomon SD; PARADIGM-HF Investigators.
出处：
J Am Coll Cardiol. 2016 Jul 19;68(3):241-8.
内容介绍：来自布莱根妇女医院的 Akshay S. Desai 博士和同事对 PARADIGM-HF 队列数据进行了分析，评估 sacubitril/缬沙坦相比依那普利，是否能降低 30 天住院率。PARADIGM-HF 试验纳入了 8399 名患者，其中 1450 名患者是 HF 住院幸存者，其中 sacubitril/缬沙坦组和依那普利分别有 675 名和 775 名患者。整体而言，共发生了 2383 例再入院，其中 sacubitril/缬沙坦组和依那普利组分别有 45.2% 和 54.8%。数据显示，sacubitril/缬沙坦组和依那普利组的 30 天全因再入院率分别为 17.8% 和 21%(OR = 0.74; 95% CI, 0.56-0.97)；心衰再入院率分别为 9.7% 和 13.4%(OR = 0.62; 95% CI, 0.45-0.87)。将时间窗口延长到 60 天后，以上结果或两组间差异并没有发生变化；校正其他混杂因素后，结果仍同上。研究表明，对于射血分数下降的心衰患者，ENTRESTO 比依那普利更有效。
摘要展示：
BACKGROUND：
Patients with heart failure (HF) are at high risk for hospital readmission in the first 30 days following HF hospitalization.
OBJECTIVES：
This study sought to determine if treatment with sacubitril/valsartan (LCZ696) reduces rates of hospital readmission at 30-days following HF hospitalization compared with enalapril.
METHODS：
We assessed the risk of 30-day readmission for any cause following investigator-reported hospitalizations for HF in the PARADIGM-HF trial, which randomized 8,399 participants with HF and reduced ejection fraction to treatment with LCZ696 or enalapril.
RESULTS：
Accounting for multiple hospitalizations per patient, there were 2,383 investigator-reported HF hospitalizations, of which 1,076 (45.2%) occurred in subjects assigned to LCZ696 and 1,307 (54.8%) occurred in subjects assigned to enalapril. Rates of readmission for any cause at 30 days were 17.8% in LCZ696-assigned subjects and 21.0% in enalapril-assigned subjects (odds ratio: 0.74; 95% confidence interval: 0.56 to 0.97; p = 0.031). Rates of readmission for HF at 30-days were also lower in subjects assigned to LCZ696 (9.7% vs. 13.4%; odds ratio: 0.62; 95% confidence interval: 0.45 to 0.87; p = 0.006). The reduction in both all-cause and HF readmissions with LCZ696 was maintained when the time window from discharge was extended to 60 days and in sensitivity analyses restricted to adjudicated HF hospitalizations.
CONCLUSIONS：
Compared with enalapril, treatment with LCZ696 reduces 30-day readmissions for any cause following discharge from HF hospitalization.
