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A Cohort Study to Compare the Hospitalization Between Naive Sacubitril/Valsartan and Naive ACEi/ARBs Heart Failure Patients With Reduced Ejection Fraction Using Secondary US Electronic Health Records Data

Completed
Conditions
Heart Failure
Interventions
Registration Number
NCT05096143
Lead Sponsor
Novartis Pharmaceuticals
Brief Summary

A non-interventional retrospective cohort study conducted to compare the naive sacubitril/valsartan Heart Failure with reduced Ejection Fraction (HFrEF) patient population to a matched naive ACEi/ARB HFrEF patient population.

Detailed Description

This was a non-interventional retrospective cohort study using the US secondary EHR dataset, Optum EHR, to compare the naive sacubitril/valsartan HFrEF patient population (aged ≥ 18 years) to a matched naive ACEi/ARB HFrEF patient population.

The study comprised of the following periods:

Identification period: 01-Jul-2015 to 31-Mar-2019

Study period

* 01-Jul-2014 to 31-Mar-2020 for primary objective and secondary objective 2 to 6.

* 01-Jul-2008 to 30-Sep-2020 for secondary objective 1.

Follow-up period: Patients were followed up until 31-Mar-2020, death or patient transfer out.

Baseline period: 365 days prior to index

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
42269
Inclusion Criteria

Sacubitril/valsartan incident cohort Included patients

  • Prescribed sacubitril/valsartan within the identification period (01-July-2015 to 31-Mar-2019), that had non-missing gender and year of birth data.
  • With at least one ICD-9-CM or ICD-10-CM code for diagnosis of HF within one-year prior to date of first prescription of sacubitril/valsartan (index date), and are treated as part of the integrated delivery network.
  • With first month active 365 days prior to index and last date active was greater than or equal to (≥) index, and the month of provider source data was greater than the final date of patient follow-up.
  • That were ≥18 years old at index date.
  • With a valid LVEF value ≤40%, prior to index (index date included).

Angiotensin-converting enzyme inhibitors (ACEi) and Angiotensin II receptor antagonist (ARB) incident cohort

Included patient:

  • Prescribed ACEi or ARBs within the identification period (01-Jul-2015 to 31-Mar-2019), that had non-missing gender and year of birth data.
  • With at least one ICD-9-CM or ICD-10-CM code for diagnosis of HF within one-year prior to date of first prescription of ACEi or ARB (index date), and were treated as part of the integrated delivery network.
  • With first month active 365 days prior to index and last date active was ≥ index, and the month of provider source data is greater than the final date of patient follow-up.
  • That were ≥ 18 years old at index date.
  • With a valid LVEF value ≤ 40%, prior to index (index date included).
Exclusion Criteria

Sacubitril/valsartan incident cohort

Excluded patients for the primary objective and secondary objective 2 to 6:

  • Patients who were prescribed sacubitril/valsartan within one-year prior to index date.
  • Patients who were prescribed ACEi or ARBs, within one-year prior to index date (index date included).

Exclude patients for secondary objective 1:

  • Patients who were prescribed sacubitril/valsartan prior to index date.
  • Patients who were prescribed ACEi or ARBs prior to index date (index date included).

Angiotensin-converting enzyme inhibitors (ACEi) and Angiotensin II receptor antagonist (ARB) incident cohort

Exclude patients for the primary objective and secondary objective 2 to 6:

  • Patients who were prescribed ACEi or ARBs within one-year prior to index date.
  • Patients who were prescribed sacubitril/valsartan within one-year prior to index date (index date included).
  • Which had a valid sacubitril/valsartan prescription that enables inclusion in the sacubitril/valsartan cohort.
  • Exclude patients for secondary objective 1:
  • Patients who were prescribed ACEi or ARBs prior to index date.
  • Patients who were prescribed sacubitril/valsartan prior to index date (index date included).
  • Which had a valid sacubitril/valsartan prescription that enables inclusion in the sacubitril/valsartan cohort

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Naive ACEi/ARBACEi/ARBParticipants who were prescribed with Naive Angiotensin-converting enzyme inhibitors/Angiotensin II receptor antagonists (ACEi/ARB)
Naive Sacubitril/valsartanSacubitril/valsartanParticipants who were prescribed with Naive Sacubitril/valsartan
Primary Outcome Measures
NameTimeMethod
Rate of Heart Failure (HF) hospitalizations events for both Naive sacubitril/valsartan HFrEF patients and Naive ACEi/ARB Heart Failure with reduced Ejection Fraction (HFrEF) patientsthrough study completion, maximum 5 years

Heart failure hospitalizations were defined by ICD-9-CM (The International Classification of Diseases, 9th Revision, Clinical Modification) and ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modifier) codes for HF listed within the primary diagnoses associated with a hospitalization that occurred during the follow-up period.

Secondary Outcome Measures
NameTimeMethod
Time to first all-cause hospitalizations events between Naive sacubitril/valsartan HFrEF patients and Naive ACEi/ARB HFrEF patientsthrough study completion, maximum 5 years

All-cause hospitalizations were defined as any hospitalization that occurred during the follow-up period.

Rate of HF hospitalizations events for both Truly naive sacubitril/valsartan HFrEF patients and Truly naive ACEi/ARB HFrEF patientsthrough study completion, maximum 5 years

Heart failure hospitalizations were defined by ICD-9-CM (The International Classification of Diseases, 9th Revision, Clinical Modification) and ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modifier) codes for HF listed within the primary diagnoses associated with a hospitalization that occurred during the follow-up period.

Time to first HF hospitalization for both Naive sacubitril/valsartan HFrEF patients and Naive ACEi/ARB HFrEF patientsthrough study completion, maximum 5 years

Heart failure hospitalizations were defined by ICD-9-CM (The International Classification of Diseases, 9th Revision, Clinical Modification) and ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modifier) codes for HF listed within the primary diagnoses associated with a hospitalization that occurred during the follow-up period.

Rate of HF hospitalizations or Emergency room (ER) visits for both Naive sacubitril/valsartan HFrEF patients and Naive ACEi/ARB HFrEF patientsthrough study completion, maximum 5 years

HF ER visits were defined by ICD-9-CM and ICD-10-CM codes for HF listed within the primary diagnoses associated with ER visits that occurred during the follow-up period.

Time to first HF hospitalization or HF ER visit for both Naive sacubitril/valsartan HFrEF patients and Naive ACEi/ARB HFrEF patientsthrough study completion, maximum 5 years

HF ER visits were defined by ICD-9-CM and ICD-10-CM codes for HF listed within the primary diagnoses associated with ER visits that occurred during the follow-up period.

Rate of all-cause hospitalizations events between Naive sacubitril/valsartan HFrEF patients and Naive ACEi/ARB HFrEF patientsthrough study completion, maximum 5 years

All-cause hospitalizations were defined as any hospitalization that occurred during the follow-up period.

Rates of cardiovascular hospitalization events between Naive sacubitril/valsartan HFrEF patients and Naive ACEi/ARB HFrEF patientsthrough study completion, maximum 5 years

The rate of cardiovascular hospitalization events between Naive sacubitril/valsartan HFrEF patients and Naive ACEi/ARB HFrEF patients was reported

Trial Locations

Locations (1)

Novartis Investigative Site

🇺🇸

East Hanover, New Jersey, United States

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