{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T22:58:06Z","timestamp":1773701886290,"version":"3.50.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":1071,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Guidelines classify sacubitril\/valsartan as a significant part of medical treatment of heart failure with reduced ejection fraction (HFrEF). Data have shown that the HbA1c levels in patients with diabetes mellitus could be impacted by sacubitril\/valsartan. A possible positive effect in diabetes patients treated with sacubitril\/valsartan on outcome and echocardiography parameters is not well studied yet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of the present study was to compare the impact of sacubitril\/valsartan on life-threatening arrhythmias, atrial fibrillation, different echocardiography parameters and congestion rate in patients suffering from HFrEF according to the diagnosis diabetes mellitus or no diabetes mellitus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Consecutive 240 patients with HFrEF from 2016 to 2020 were treated with sacubitril\/valsartan and separated to concomitant diabetes mellitus (n = 87, median age 68 years interquartile range (IQR) [32\u201387]) or no diabetes mellitus (n = 153, median age 66 year IQR [34\u201389]). Different comorbidities and outcome data were evaluated over a follow-up period of 24 months. Arterial hypertension (87% vs. 64%; P &amp;lt; 0.01) and coronary artery disease (74% vs. 60%; P = 0.03) were more often documented in patients with diabetes mellitus compared with patients without diabetes mellitus. Over the follow-up of 24 months several changes were noted in both subgroups: Median left ventricular ejection fraction (EF) increased significantly in non-diabetes (27% IQR [3\u201344] at baseline to 35% IQR [13\u201364]; P &amp;lt; 0.001), but not in diabetic patients (29% IQR [10\u201365] at baseline to 30% IQR [13\u201355]; P = 0.11). Accordingly, NT-proBNP and troponin-I levels decreased significantly in non-diabetes patients (NT-brain natriuretic peptide [NT-proBNP] from median 1445 pg\/mL IQR [12.6\u201374 676] to 491 pg\/mL IQR [13\u20134571]; P &amp;lt; 0.001, troponin-I levels from 0.099 ng\/mL IQR [0.009\u2013138.69] to 0.023 ng\/mL IQR [0.006\u20130.635]; P &amp;lt; 0.001), but not in diabetic patients (NT-proBNP from 1395 pg\/mL IQR [100\u201329 924] to 885 pg\/mL IQR [159\u20134331]; P = 0.06, troponin-I levels from 0.05 ng\/mL IQR [0.013\u2013103.0] to 0.020 ng\/mL IQR [0.015\u20130.514]; P = 0.27). No significant change of laboratory parameters e. g. glomerular filtration rate, potassium level and creatinine levels were found in diabetes or non-diabetes patients. Comparing further echocardiography data, left atrial surface area, right atrial surface area, E\/A ratio did not show a significant change either in the diabetes or non-diabetes group. However, the tricuspid annular plane systolic excursion was significantly increased in non-diabetes mellitus patients (from 17 mm IQR [3\u201331] to 18 mm [2.5\u201331]; P = 0.04), and not in diabetic s patients (17.5 mm IQR [8\u201330] to 18 mm IQR [14\u201331]; P = 0.70); the systolic pulmonary artery pressure remained unchanged in both groups. During follow-up, a similar rate of ventricular tachyarrhythmias was observed in both groups. The congestion rate decreased significantly in both groups, in diabetes patients (44.4% before sacubitril\/valsartan and 13.5% after 24 months treatment; P = 0.0009) and in non-diabetic patients (28.4% before sacubitril\/valsartan and 8.4% after 24 months treatment; P = 0.0004). The all-cause mortality rate was higher in patients with diabetes mellitus as compared with those without diabetes (25% vs. 8.1%; P &amp;lt; 0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sacubitril\/valsartan reverses cardiac remodelling in non-diabetes patients. However, it reduces the congestion rate in diabetes and non-diabetes patients. The rates of ventricular tachyarrhythmias were similar in DM compared with non-DM over follow-up. The mortality rate remained to be over follow-up higher in diabetes patients compared with non-diabetes; however, it was lower compared with published data on diabetes and concomitant HFrEF not treated with sacubitril\/valsartan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14239","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T12:56:11Z","timestamp":1670417771000},"page":"943-954","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Impact of Sacubitril\/Valsartan on Outcome in Patients Suffering from Heart Failure with a Concomitant Diabetes Mellitus"],"prefix":"10.1093","volume":"10","author":[{"given":"Ibrahim","family":"El-Battrawy","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil University Hospitals, Ruhr University of Bochum , 44789, Bochum 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