Vicent, LourdesAyesta, AnaEsteban Fernández, AlbertoGómez Bueno, ManuelJuan Bagudá, Javier deDíez Villanueva, PabloIniesta, Ángel ManuelRojas González, AntonioPerea Egido, Jesus ÁngelMartínez Sellés Oliveria Soares, ManuelEt al.2019-06-172019-06-172019Vicent, L., Ayesta, A., Esteban-Fernández, A., Gómez-Bueno, M., De-Juan, J., Díez-Villanueva, P., ... & Martínez-Sellés, M. (2019). Sex Influence on the Efficacy and Safety of Sacubitril/Valsartan. Cardiology, 142(2), 73-78. https://doi.org/10.1159/0004989840008-63121421-9751http://hdl.handle.net/11268/8045BACKGROUND: Women are underrepresented in sacubitril/valsartan (SV) clinical trials. The aim of this study was to assess sex-specific differences in efficacy, tolerability, and safety of SV in real-world heart failure with reduced ejection fraction (HFrEF) patients. METHODS: A prospective registry in 10 centers including all patients who started SV during the last 6 months was analyzed in this study. RESULTS: A total of 427 patients were included, 126 (29.5%) were women. There were no substantial differences in HFrEF treatment before SV initiation, although fewer women than men carried an implantable cardioverter defibrillator (57 [45.2%] vs. 173 [58.1%], p = 0.02). SV starting dose was 24/26 mg b.i.d. in 206 patients (48.2%), 49/51 mg b.i.d. in 184 (43.1%), and 97/103 mg b.i.d. in 34 (8.2%), without relevant differences associated to sex. There were no losses during a mean follow-up of 7.0 ± 0.1 months. The proportion of patients who discontinued the drug (16 [12.7%] women vs. 33 [11.0%] men, p = 0.66) or presented SV-related adverse effects (31 [24.6%] women vs. 79 [26.5%] men, p = 0.72) was also similar in both sexes. However, female sex was an independent predictor of functional class improvement in the multivariate analysis (odds ratio 2.33, 95% confidence interval: 1.24-4.38, p = 0.04). CONCLUSIONS: SV in women with HFrEF has a similar tolerability as in men. Females seem to have a more frequent functional class improvement than males.engjournal article10.1159/000498984restricted accessFarmacología cardiovascularDiferencias entre los sexosFarmacologíaEnfermedad cardiovascular