Treatment of Heart Failure with Sacubitril/Valsartan in Hondurans with reduced left ventricular ejection fraction: Three-year experience.

Background: Heart Failure with Reduced Ejection Fraction (HFrEF) is a paramount medical condition affecting more than 23 million individuals worldwide. It is one of the leading causes of morbidity and mortality, particularly in the western world, making it a vital topic of discussion in the current clinical trials.
Objective: This study aimed to describe the response to sacubitril/valsartan in a group of Hondurans with heart failure and reduced Left Ventricular Ejection Fraction (LVEF) between January 2018 and June 2020.
Methods: This observational, descriptive, retrospective cohort study was conducted on 105 adult patients with HFrEF who received treatment with angiotensin-receptor antagonist/neprilysin inhibitors (sacubitril/valsartan) in a single medical center in Honduras. The study participants included the patients with LVEF < 40% treated with sacubitril/valsartan for at least one year. The patients also received optimal medical therapy for HFrEF according to the American Heart Association guidelines. The data were analyzed using the SPSS 25.0 software.
Results: The results showed that the main etiology of HFrEF was ischemic heart disease (41%). The LVEF changed from a median of 30% to 45% after one year of treatment. Additionally, the overall Glomerular Filtration Rate (GFR) remained unchanged. However, the N-Terminal Pro B-type Natriuretic Peptide (NT-ProBNP) decreased from a median of 8800 pg/mL to 1900 pg/mL after 12 months.
Conclusions: The study population had sociodemographic and clinical similarities with the Latin American Cohort in the PARADIGM-HF trial with the significant improvement of the LVEF and functional class. However, the median level of NT-ProBNP was 8800 pg/mL at baseline in the current study, which was dramatically higher than 1760 pg/mL reported in the PARADIGM-HF trial, suggesting the need for further analyses in the Honduran population.