Descripción de la efectividad terapéutica de sacubitril/valsartán vs enalapril en pacientes de 40 - 70 años con insuficiencia cardíaca congestiva y fracción de eyección <40% en el Hospital de Especialidades Teodoro Maldonado Carbo durante el período 2017-2019.

Abstract

Background: Based on the PARADIGM-HF study, Sacubitril/Valsartán was approved as part of the treatment of congestive heart failure with reduced ejection fraction, comparing it with enalapril to determine its influence on life`s quality in patients. Objective: To describe the therapeutic effectiveness of Sacubitril/Valsartan vs Enalapril in patients aged 40-70 years with congestive heart failure and reduced ejection fraction. Materials and methods: A descriptive, observational, retrospective, non-randomized cohort study was carried out using the medical records of Teodoro Maldonado Carbo Specialty Hospital during January 2017- December 2019. The initial population was 9000 patients diagnosed with heart failure, which was reduced to 131 patients divided according to the treatment received: 34 in Sacubitril / Valsartan and 88 in Enalapril. Results: Cross tables were made to compare the decrease in functional grade with the use of Sacubitril/Valsartan (65.12%) and with Enalapril (38.63%) (RR = 0.481). The 50 to 60-year-old group presented a greater decrease in functional grade with Sacubitril/Valsartan and Enalapril treatment (p= 0.035). The most frequent adverse effect with Sacubitril/Valsartan was hypotension (11.62%) and with Enalapril was cough (39.8%). Hospital readmission and mortality with Sacubitril/Valsartan treatment were 27.9% and 18.6%, while in Enalapril group were 59.1% and 29.5% respectively. Conclusion: Sacubitril/Valsartan treatment shows superiority over Enalapril, improving life quality in patients with congestive heart failure and reduced ejection fraction.