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Effectiveness of sacubitril/valsartan for reducing pulmonary artery pressure in patients with pulmonary hypertension and heart failure: A systematic review and meta-analysis (ID 547)

El-Sherif R, El-Sherif A, Roberts N, Kartsonaki C

The Queen Elizabeth Hospital King's Lynn

Funding: None

Abstract

Background:
Patients with heart failure (HF) commonly develop pulmonary hypertension (PH). This is associated with an increased risk of mortality and morbidity. Currently, medical therapies are inadequate and have failed to reduce pulmonary artery pressure (PAP). A previous systematic review has demonstrated that sacubitril/valsartan reduces PAP in patients with HFrEF, but limited the method of PAP measurement to echocardiography. Furthermore, there is limited research investigating the use of sacubitril/valsartan in HFpEF and PH. Therefore, we aim to determine the effectiveness of sacubitril/ valsartan for reducing PAP in patients who have PH and HFrEF or HFpEF. We also aim to improve the generalisability of the current findings by expanding the method of PAP measurement to echocardiography, right heart catheterisation and CardioMems.

Methods:
This study was designed in accordance with the Cochrane protocol for systematic reviews and PRISMA guidelines. The protocol is registered on PROSPERO (CRD42024507082) and is available on: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024507082

Briefly, a search of Medline and EMBASE databases was performed and studies which investigated the changes in PAP pre and post administration of sacubitril/valsartan in patients with HF and PH were included. The main outcomes are changes in mean, systolic and diastolic PAPs. As secondary outcomes, we will investigate changes in NTproBNP and NYHA classification pre and post administration of sacubitril/valsartan in HF and PH. Fixed and random effects meta-analysis will be used to estimate weighted mean differences. Subgroup analysis will be performed for gender and method of PAP measurement, and meta-regression will be performed for age, severity of HF and severity of PH.

Results:
This study is a work in progress. A preliminary search identified 3325 studies, which will be screened for inclusion. The presentation will include a meta-analysis of mean, systolic and diastolic PAPs in HFpEF and PH.

Conflicts of interest: None

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