Potential Mortality Reduction With Optimal Usage of Sacubitril/Valsartan Therapy for The Treatment of Heart Failure In Argentina

  • Bianculli P
  • Volman S
  • Barbeau M
  • et al.
Citations of this article
Mendeley users who have this article in their library.


Objectives: PARADIGM-HF, a phase III trial conducted in patients with heart failure with reduced ejection fraction (HFrEF), showed that sacubitril/valsartan, a first-inclass angiotensin receptor neprilysin inhibitor, provided incremental cardiovascular and overall survival benefit compared with enalapril. This analysis aims to quantify the number of all-cause deaths that potentially could be avoided with optimal usage of sacubitril/valsartan in the treatment of HFrEF in Brazil. Methods: Data from Instituto Brasileiro de Geografia e Estatística was used to quantify the target population. A literature review was conducted to determine the prevalence of HF, the proportion of NYHA Class II-IV and finally, the proportion of HFrEF patients. The number needed to treat (NNT) to avoid one death due to any cause, standardized to 12 months, was derived from the PARADIGM-HF trial. The number of all-cause deaths that might be potentially prevented or postponed as a result of treatment with sacubitril/valsartan was estimated along with multiple-way sensitivity analysis. The main outcome measure was all-cause mortality. Results: The 2017 population (≥ 20 years) in Brazil was estimated at 144,323,520 and the estimated prevalence of HF was 2%, which was applied to determine the number of HF patients. The percentage of diagnosed HF patients was 60%. Of these, 85% were NYHA Class II-IV; 41% of these patients had HFrEF. This equated to 603,561 patients with HFrEF NYHA class II-IV. Finally, absolute reduction in all-cause mortality in PARADIGM-HF was 2.8% over an average follow-up time of 27 months. This translates into a NNT, standardized to 12 months, of 80.3; thus, optimal usage of sacubitril/valsartan therapy was estimated to prevent 7,516 deaths each year. Conclusions: The findings suggest that a substantial number of deaths could potentially be prevented by optimal implementation of sacubitril/valsartan therapy. Implementation of sacubitril/valsartan into routine clinical practice is important, and may substantially improve clinical outcomes among HFrEF patients in Brazil.




Bianculli, P., Volman, S., Barbeau, M., MacPherson, A., Haroun, R., & Giorgi, M. (2017). Potential Mortality Reduction With Optimal Usage of Sacubitril/Valsartan Therapy for The Treatment of Heart Failure In Argentina. Value in Health, 20(9), A918. https://doi.org/10.1016/j.jval.2017.08.2853

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free