The Management Outcome of Heart Failure Reduced Ejection Fraction with or without Angiotensin Receptor Neprilysin Inhibitor

Abstract

INTRODUCTION: Heart failure is associated with recurrent admission, higher mortality and low quality of life. Angiotensin receptor neprilysin inhibitor (ARNI) is a novel agent that has been used for treating heart failure reduced ejection fraction (HFrEF) patients. Thus, it is interesting to evaluate the effect of ARNI on the reverse cardiac remodelling, rehospitalization, cardiac biomarker and quality of life in HFrEF patients. MATERIALS AND METHODS: A case controlled study was conducted to assess the treatment outcome of HFrEF with or without ARNI. During the study, the patients’ basic demography, co-morbidities, baseline echocardiography (ECHO) findings, NYHA classification, NT-pro BNP levels and KCCQ score were evaluated. The patients’ admission history within 90 days from initiation of ARNI or non ARNI were obtained retrospectively. A follow up ECHO was obtained after at least 3 months of intervention. RESULTS: A total of 81 patients were recruited in which 54 patients were on ARNI and 27 were on non ARNI treatment. There was a statistically significant improvement of ejection fraction, left ventricular internal diameter end diastole and systole, and left ventricular end-systolic volume in ARNI group. The NYHA class was also noted to improve after ARNI treatment. The NT-proBNP value was lower whereas the KCCQ score was higher in ARNI group compared to non ARNI group. CONCLUSION: HFrEF patients with ARNI treatment had better reverse cardiac remodelling effect, cardiac biomarker and quality of life compared to non ARNI treatment. Furthermore, patient received ARNI demonstrated improved heart failure classification after treatment