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Novel doses of sacubitril/valsartan in patients unable to tolerate traditional therapy: Effects on N‐terminal pro B‐type natriuretic peptide levels

Clinical Cardiology Dec 19, 2020

Pandey AC, Jer D, Kuo RS, et al. - This study was attempted to evaluate whether lower than standard doses of angiotensin receptor blocker and neprilysin inhibitor (ARNI), sacubitril/valsartan (S/V), significantly reduces NT‐proBNP and leads to any change in diuretic dose, serum potassium, or creatinine. Researchers conducted a retrospective study including a total of 278 individuals who were started on a low dose S/V at a single medical center, 45 individuals were selected for the study cohort. Individuals were subclassified to Group 1 (n = 10): very low dose S/V (half a tab of 24/26 mg BID), Group 2 (n = 10): very low dose titrated to low dose S/V, and Group 3 (n = 25): low dose S/V (24/26 mg BID). They compared NT‐proBNP, diuretic dose, serum potassium, and creatinine before and after initiation of S/V. The outcomes of this study exhibited that a lower than the standard dose of S/V significantly decreases NT‐proBNP and diuretic requirement without a change in potassium or creatinine, which gives hope that individuals who cannot tolerate standard doses of S/V due to hypotension may be able to receive the advantages of S/V therapy.

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