P3373Better health-related quality of life in patients treated with sacubitril/valsartan compared with enalapril, irrespective of NYHA class: Analysis of EQ-5D in PARADIGM-HF

Abstract

right heart chambers due to significant decreasing of the HR. 6MWT showed that pts of the 2nd gr were able to walk 121,3±17,6 meters more than pts of the 1st gr.Estimating results of SF-36 it was found that pts of 2nd group had significant improvement at such scales as RPF, GH, Vitality, RE and MH comparing to pts of the 1st gr. Conclusion: 6 MWT confirmed efficacy of ivabradin in pts with CCP and RHF. Early prescription of ivabradine in this cohort of pts prevents worsening of RHFim-proving the structure-functional data of the right heart chambers, which has a positive influence on life quality of these pts. Background: Cardiac reverse remodeling (CRR) is considered as a surrogate marker for favorable prognosis of non-ischemic dilated cardiomyopathy (NIDCM). Based on the results of large clinical trials, the current guidelines recommended the administration of mineralocorticoid receptor antagonist (MRA) to reduce mortality and HF hospitalization in all symptomatic heart failure (HF) patients with reduced ejection fraction despite treatment with ACE inhibitors/ARB and beta-blockers. However, the efficacy of the MRA for asymptomatic HF patients (AHA/ACC stage B) has not been established. Purpose: The purpose of this study was 1) to investigate the association between MRA and CRR and 2) the prognostic value of additional MRA administration in asymptomatic NIDCM patients. Methods: We enrolled 122 NIDCM patients classified AHA/ACC stage B HF in this retrospective cohort study. NIDCM was defined by the presence of left ven-tricular ejection fraction <50% on echocardiography and a dilated LV cavity, in the absence of coronary heart disease, valvular heart disease, or secondary cardiac muscle disease caused by any known systemic condition. All patients were divided into two groups; with-MRA group and without-MRA group. CRR was defined as an absolute increase in left ventricular ejection fraction ≥10% accompanied by a decrease in left ventricular end-diastolic diameter >10% as assessed by echocardiography at 12 months. The cardiac event was defined as composite outcome including cardiac-related death, ICD/CRTD implantation and unplanned hospitalization for worsening HF within 12 months. Results: As for baseline characteristics, the mean of left ventricular ejection fraction and end-diastolic diameter was 33.2% and 62.5 mm, respectively. The administration rate of ACE inhibitors/ARBs and was 84% and 87%. Sixty-three (52%) patients were treated with MRA. The rate of CRR was significantly higher in patients treated with MRA than in patients without MRA (52% vs 29%, p=0.033; Figure A). In Kaplan-Meier survival analysis, the cardiac event-free rates were comparable between two groups (Log-rank, p=0.95; Figure B). Conclusions: The early administration of MRA for Stage B HF is useful for CRR in NIDCM patients; however the impact on 12-months prognosis are not demonstrated. Further prospective large-scale studies with long-term follow-up in Stage B HF patients are needed. Background: The totality of a patient's health-related quality of life (HRQL) experience may be better assessed by a generic rather than a disease-specific instrument. We assessed HRQL with a validated and widely used generic instrument,