COMPARISON OF EFFECTIVENESS OF ISOSORBID DINITRATE/ HYDRALAZINE COMBINATION WITH SACUBITREL/ VALSARTAN IN CHF AMONG INDIAN PATIENTS

Abstract

Background: To compare the effectiveness of Isosorbid dinitrate/ hydralazine combination with Sacubitrel/ Valsartan in CHF in Indian patients.
Methods: One hundred ten CHF patients of both genders were divided into 2 groups of fifty- five each. Group I patients received Sacubitrel/ Valsartan and group II patients received Isosorbid dinitrate/ hydralazine. Effectiveness of both drug combination was compared.
Results: Clinical features recorded was ischaemic cardiomyopathy in 32 and 38 in group I and II patients respectively. LVEF found to be 29.1% and 29.4%. Medium B type natriuretic peptide level was 254 pg/ml and 255 pg/ml in group I and II patients respectively. NYHA functional class I was seen in 8 and 7, class II in 23 and 25, class III in 20 and 21 and class IV in 4 and 2 respectively. Medical history was diabetes seen in 21 and 9, hypertension in 17 and 14, atrial fibrillation in 11 and 12, stroke in 6 and 5 and myocardial infarction in 2 and 4 in group I and II patients respectively. SBP (mm Hg) was 126.8 and 124.6 and heart rate (beats/ min) was 70.2 and 74.6. Treatment given was digitalis in 42 and 52, B- blocker in 31 and 37, diuretic in 27 and 30 and mineralocorticoid antagonist in 13 and 16 patients in group I and II respectively. The difference was non- significant (P>0.05). Adverse events were hypotension in 6 and 2, serum creatinine >3.0 mg/dl seen in 2 and 4, serum potassium >5.5 mmol/l was seen in 5 and 9, angioedema in 6 and 8 and cough in 2 and 1 patients in group I and II respectively. The difference was significant (P< 0.05).
Conclusion: The combination of Sacubitrel/ Valsartan in CHF patients was found to be effective as compared to Isosorbid dinitrate/ hydralazine. However, large scale studies are required to substantiate the results obtained in this study