Angiotensin receptor neprilysin inhibitor for patients with heart failure and reduced ejection fraction: Real-world experience from Turkey (ARNi-TR)

Ekici B., Yaman M., KÜÇÜK M., Dereli S., Yenerçaǧ M., YİĞİT Z., ...More

Turk Kardiyoloji Dernegi Arsivi, vol.49, no.5, pp.357-367, 2021 (ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 49 Issue: 5
  • Publication Date: 2021
  • Doi Number: 10.5543/tkda.2021.63099
  • Journal Name: Turk Kardiyoloji Dernegi Arsivi
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE, MEDLINE, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.357-367
  • Keywords: Angiotensin receptor neprilysin inhibitor, heart failure with reduced ejection fraction, sacubitril, valsartan, real-world, SACUBITRIL/VALSARTAN IMPROVES, ENALAPRIL, DISEASE
  • Lokman Hekim University Affiliated: Yes


© 2021 Turkish Society of Cardiology.Objective: Heart failure (HF) is a growing public health problem with high morbidity and mortality. Recently, angiotensin receptor neprilysin inhibitor (ARNi) has emerged as a promising treatment for HF with reduced ejection fraction (HFrEF). Here, we shared our experience with the use of ARNi in HFrEF from multiple centers in Turkey.Methods: The ARNi-TR is a multicenter, noninterventional, retrospective, observational study. Overall, 779 patients with HF from 22 centers in Turkey who were prescribed sacubitril/valsartan were examined. Initial clinical status, biochemical and echocardiographic parameters, and New York Heart Association functional class (NYHA-FC) values were compared with follow-up values after 1 year of ARNi use. In addition, the effect of ARNi on number of annual hospitalizations was investigated, and the patients were divided into 2 groups, depending on whether ARNi was initiated at hospitalization or under outpatient clinic control.Results: N-terminal pro-brain natriuretic peptide (NT-proBNP), left-ventricle ejection fraction (LV-EF), and NYHA-FC values improved significantly in both groups (all parameters, p<0.001) within 1-year follow-up. In both groups, a decrease in hemoglobin A1c (HbA1c) values was observed in ARNi use (p<0.001), and a decrease in daily diuretic doses and hospitalizations owing to HF were observed after ARNi use (all comparisons, p<0.001). Hypotension (16.9%) was the most common side effect in patients using ARNi. Conclusion: The ARNi-TR study offers comprehensive real-life data for patients using ARNi in Turkey. The use of ARNi has shown significant improvements in FC, NT-proBNP, HbA1c levels, and LV-EF. Likewise, reductions in the number of annual hospitalizations and daily furosemide doses for HF were seen in this study.