Efficacy of sacubitril/valsartan versus losartan in heart failure patients with respect to improvements in ejection fraction and New York Heart Association functional class

Abstract

Background: Heart failure (HF) is a complicated clinical disease that develops when the Left ventricular becomes symptomatic due to anatomical or functional ventricular malfunction. The symptoms emerge from a cardiac output that is insufficient to meet the body's metabolic needs. Globally, HF has emerged as a major health issue, with an estimated prevalence of >37.7 million. While HF with reduced ejection fraction (HFrEF) is more frequently seen in Indian patients, HF with preserved EF seems to be more prevalent in the western population. Objective: This study was conducted to determine the efficacy of sacubitril/valsartan (S/V) versus losartan in patients with HF with respect to improvements in EF and New York Heart Association (NYHA) functional class symptoms. Materials and Methods: A prospective cohort study was conducted on 62 HF patients who are either on angiotensin receptor-neprilysin inhibitor or angiotensin receptor blocker therapy for a period of 6 months, i.e., November 2021 to April 2022, who attended the Inpatient Cardiology Department of Narayana Medical College and Hospital. By using a semi-structured questionnaire, the data was gathered. The 2013 edition of Microsoft Excel and SPSS version 20.0 software were used for data analysis. Results: Subjects in the S/V group showed a 56% reduction in subjects with HFrEF from the beginning to end of the follow-up, while subjects in the losartan group showed only 16% reduction. With respect to NYHA functional class, subjects in the S/V group showed greater reduction in subjects in NYHA class III and NYHA class IV by the end of follow-up when compared to the losartan group. Conclusion: S/V showed better efficacy in improving EF and NYHA functional class when compared to losartan.