| Objecttive: To understand the application status of sacubitril/valsartan sodium tablets in patients with heart failure(Hear failure ejection fraction,HFr EF)with reduced ejection fraction,as well as the dose changes and efficacy analysis of sacubitril/valsartan sodium tablets in Dali area.Methods: A retrospective analysis of patients with HFr EF who were treated with sacubitril/valsartan sodium tablets in the First Affiliated Hospital of Dali University from September 2018 to September 2020,and recorded the basic data of patients’ admission and related indicators of heart failure(blood pressure,biochemical)Indicators,cardiac color Doppler ultrasound indicators,the number of hospitalizations for heart failure one year before treatment,etc.)and heart failure medication;record the follow-up results within one year,including: questionnaire survey,vital signs,renal function,blood potassium,cardiac color Doppler ultrasound indicators,etc.The results are researched and analyzed.Results:(1)Among the 229 patients included in the study,17.5% had an initial dose lower than the initial dose recommended by the guidelines(50 mg twice a day).During the titration process,84.3% of the patients maintained the initial dose prescribed by the doctor,and only 2.6% titrated to the target The dose(200mg each time,twice a day),97.4% of patients did not titrate to the target dose.The reasons for the overwhelming majority of patients who do not meet the standards include inadequate medical advice(35.0%),adverse reactions(22.9%),self-awareness(15.7%),economic income(14.3%),access to medicines(8.1%),Patients with poor basic renal function(3.1%)and limited drug side effects(0.9%).(2)Among the 229 patients,221(96.5%)patients had a heart failure course of more than 1 year.Among 221 patients,compared with the hospitalization rate for heart failure within 1 year before treatment,the hospitalization rate for heart failure within 1 year after treatment was reduced by 20.8%,and the difference was statistically significant(P value <0.001).(3)Among the 229 patients,after taking sacubitril/valsartan sodium tablets for 1 year,the cardiac function classification was better than that before treatment,and the difference was statistically significant(P value<0.001).(4)37 patients completed the 3-month follow-up of cardiac color Doppler ultrasound results.Compared with before treatment,LVEF was significantly higher than before(P value <0.001),and LVEDD and LVESD were significantly reduced(P value <0.001),and the difference was statistically significant.significance.(5)Thirty patients completed the 6-month follow-up of cardiac color Doppler ultrasound results.Compared with before treatment,LVEF was significantly higher than before(P value <0.001),and LVEDD and LVESD were significantly reduced(P value<0.001),and the difference was statistically significant.significance.(6)36 patients completed the 12-month follow-up of cardiac color Doppler ultrasound results.Compared with before treatment,LVEF was significantly higher than before(P value <0.05),and LVEDD and LVESD were significantly reduced(P value <0.05),and the difference was statistically significant.significance.(7)Among the 117 patients who completed the follow-up of cardiac color Doppler ultrasound,the average dose of sacubitril/valsartan sodium tablets was positively correlated with △ LVEF(r=0.60,P value<0.001),and negatively correlated with △LVEDD(r=-0.25,P value<0.05),and negatively correlated with △LVESD(r=-0.35,P value<0.001).The closer the average dose is to the target dose,the more significant the improvement of cardiac function and the better the effect of reversing ventricular remodeling.Conclusion:(1)In the First Affiliated Hospital of Dali University,in the treatment of heart failure with sacubitril/valsartan sodium tablets,the initial dose of the drug was low,the titration process was conservative,and the target dose was only 2.6%.The reasons for drug doses not meeting the standard are closely related to many factors such as inadequate medical advice,self-cognition,economic income,adverse reactions,and inconvenience in transportation.(2)After treatment with sacubitril/valsartan sodium tablets,it can significantly reduce the hospitalization rate for heart failure,improve heart function,and reverse ventricular remodeling.(3)The closer the average dose of sacubitril/valsartan sodium tablets to the target dose,the more obvious the improvement of cardiac function and the better the effect of reversing ventricular remodeling. |
PDF Full Text Request