LAUSR

INTRODUCTION Heart failure patients discharged from the hospital are at high risk of death and rehospitalization. Scarce data are available on the use of sacubitril/valsartan in this population in Poland. OBJECTIVE To compare the efficacy and tolerability of sacubitril/valsartan in the group of Polish patients who participated in the TRANSITION study with patients recruited at other sites. PATIENTS AND METHODS This is a post-hoc secondary analysis of the TRANSITION study comparing sacubitril/valsartan initiation pre- vs. post-discharge in 991 patients hospitalized for acute decompensated HFrEF. The Polish subgroup consisted of 104 patients. RESULTS Significant differences were identified in the characteristics of Polish vs. non-Polish populations. At baseline, the Polish population showed higher proportion of men, higher BMI, lower HR, NTproBNP and hsTNT and significantly lower NYHA class. Polish patients were better managed in terms of implanted electrotherapy devices, PCI, and drug therapy and had more hospitalizations. The primary endpoint of achieving the target dose of sacubitril/valsartan at treatment week 10 was achieved by 45.6% of Polish patients vs. 48.4% of the non-Polish population (P=0.61). Approximately 90% of Polish patients received and maintained any sacubitril/valsartan dose for 2 weeks over 10 weeks' treatment vs. 87.5% of non-Polish patients (P=0.36). The rate of permanent sacubitril/valsartan treatment discontinuations was low in both Polish (3.9%) and non-Polish populations (6.4%) (P=0.33). CONCLUSIONS Sacubitril/valsartan can be used safely in the early period after episode of acute heart failure both in Polish and non-Polish patients with HFrEF and the likelihood to achieve the maximum dose is the same despite significant differences between studied populations.