CENTRAL ASIAN JOURNAL OF NEPHROLOGY
Case Report
Dec 18, 2025 144 101

Experience of Using Sacubitril/Valsartan in an Asian Patient with Comorbidities: Chronic Heart Failure, Atrial Fibrillation, and Chronic Kidney Disease

Zhuldyz Ospanova 1,
Manchuk Karzhaubayeva 2 *
1 Department of Internal Medicine/Cardiology, Almaty SEMA Hospital, Almaty, Kazakhstan2 Department of General Medical Practice, Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Al-maty, Kazakhstan* Corresponding Author
Central Asian Journal of Nephrology, 1(2), 2025, cajn010, https://doi.org/10.63946/cajn/17568
Publication date: Dec 18, 2025
Full Text (PDF)

ABSTRACT

A 68-year-old asian man was admitted with decompensated chronic heart failure with a left ventricular ejection fraction of 20%, permanent arterial fibrillation, and chronic kidney disease. Sacubitril/Valsartan (Uperio) was prescribed. This review details the initiation of sacubitril/valsartan in an Asian patient with heart failure with low ejection fraction (20%) and comorbidities. The paper highlights the pharmacodynamic and pharmacokinetic profiles of Sacubitril/Valsartan. The focus is on a thorough review of clinical trials to assess the therapeutic efficacy and potential adverse events associated with Sacubitril/Valsartan administration in this specific patient group.
Since 2014, sacubitril/valsartan has been widely prescribed for heart failure. Nevertheless, the coexistence of additional diseases such as arthritis, renal insufficiency, diabetes mellitus, or chronic lung disease with the heart failure syndrome should logically require a modification of treatment, outcome assessment, or follow-up care.

KEYWORDS

Sacubitril/Valsartan Neprilysin Chronic Heart Failure Arterial Fibrillation Chronic Kidney Disease

CITATION (Vancouver)

Ospanova Z, Karzhaubayeva M. Experience of Using Sacubitril/Valsartan in an Asian Patient with Comorbidities: Chronic Heart Failure, Atrial Fibrillation, and Chronic Kidney Disease. Central Asian Journal of Nephrology. 2025;1(2):cajn010. https://doi.org/10.63946/cajn/17568
APA
Ospanova, Z., & Karzhaubayeva, M. (2025). Experience of Using Sacubitril/Valsartan in an Asian Patient with Comorbidities: Chronic Heart Failure, Atrial Fibrillation, and Chronic Kidney Disease. Central Asian Journal of Nephrology, 1(2), cajn010. https://doi.org/10.63946/cajn/17568
Harvard
Ospanova, Z., and Karzhaubayeva, M. (2025). Experience of Using Sacubitril/Valsartan in an Asian Patient with Comorbidities: Chronic Heart Failure, Atrial Fibrillation, and Chronic Kidney Disease. Central Asian Journal of Nephrology, 1(2), cajn010. https://doi.org/10.63946/cajn/17568
AMA
Ospanova Z, Karzhaubayeva M. Experience of Using Sacubitril/Valsartan in an Asian Patient with Comorbidities: Chronic Heart Failure, Atrial Fibrillation, and Chronic Kidney Disease. Central Asian Journal of Nephrology. 2025;1(2), cajn010. https://doi.org/10.63946/cajn/17568
Chicago
Ospanova, Zhuldyz, and Manchuk Karzhaubayeva. "Experience of Using Sacubitril/Valsartan in an Asian Patient with Comorbidities: Chronic Heart Failure, Atrial Fibrillation, and Chronic Kidney Disease". Central Asian Journal of Nephrology 2025 1 no. 2 (2025): cajn010. https://doi.org/10.63946/cajn/17568
MLA
Ospanova, Zhuldyz et al. "Experience of Using Sacubitril/Valsartan in an Asian Patient with Comorbidities: Chronic Heart Failure, Atrial Fibrillation, and Chronic Kidney Disease". Central Asian Journal of Nephrology, vol. 1, no. 2, 2025, cajn010. https://doi.org/10.63946/cajn/17568

REFERENCES

  1. Loretta F. Entresto (Sacubitril/Valsartan): First-in-Class Angiotensin Receptor Neprilysin Inhibitor FDA Approved for Patients with Heart Failure. AmHealthDrugBenefits. 2015; 8(6):330–334. https://doi.org/10.1007/s11886-018-0944-4
  2. US Food and Drug Administration. FDA approves new drug to treat heart failure. Press release. July 7, 2015. www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm453845.htm. Accessed July 15, 2015.
  3. Entresto (sacubitril and valsartan) tablets [prescribing information]. East Hanover, NJ: Novartis; July 2015. https://doi.org/10.1001/jama.2015.9398
  4. Assessment report on group of an extension of marketing authorisation and an extension of indication variation. Entresto. International non-proprietary name: sacubitril/valsartan Procedure No. EMEA/H/C/004062/X/0044/G. 30 March 2023. EMA/172209/2023. Committee for Medicinal Products for Human Use (CHMP) https://www.ema.europa.eu/en/medicines/human/EPAR/entresto
  5. McMurray JJV, Packer M, Desai AS. Angiotensin–neprilysin inhibition versus Enalapril in Heart failure. N Engl J Med. 2014; 371:993–1004. https://doi.org/10.1056/nejmoa1409077
  6. McDonagh TA, Metra M, Adamo M. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2021; 42:3599–726. https://doi.org/10.1093/eurheartj/ehab670
  7. 2013 ACCF/AHA Guideline for the Management of Heart Failure A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;128:e240-e327. https://doi.org/10.3410/f.718180330.793487040
  8. Lindenfeld J, Albert NM, Boehmer JP. HFSA 2010 comprehensive heart failure practice guideline. J Card Fail. 2010; 16:e1–194. https://doi.org/10.1016/j.cardfail.2010.04.004
  9. McMurray JJ, Adamopoulos S, Anker SD. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Eur Heart J. 2012; 33:1787–847. https://doi.org/10.1093/eurheartj/ehs370
  10. Hunt SA, Abraham WT, Chin MH. 2009 Focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009; 119:e391–479. https://doi.org/10.1161/circulationaha.109.192065
  11. Virani S, Alonso A, Benjamin E. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 2020;141:e139-e596. https://doi.org/10.1161/cir.0000000000000746
  12. Dharmarajan K, Hsieh A, Lin Z. Diagnoses and timing of 30-day readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia. JAMA. 2013; 309(4):355-363. https://doi.org/10.1001/jama.2012.216476
  13. Bueno H, Ross J, Wang Y. Trends in length of stay and short-term outcomes among Medicare patients hospitalized for heart failure: 1993-2008. JAMA. 2010; 303(21):2141-2147. https://doi.org/10.1001/jama.2010.748
  14. Roger VL, Weston SA, Redfield MM. Trends in heart failure incidence and survival in a community-based population. JAMA. 2004; 292:344–50. https://doi.org/10.1001/jama.292.3.344
  15. Owan TE, Redfield MM. Epidemiology of diastolic heart failure. Prog Cardiovasc Dis. 2005; 47:320–32. https://doi.org/10.1016/j.pcad.2005.02.010
  16. Loehr LR, Rosamond WD, Chang PP. Heart failure incidence and survival (from the Atherosclerosis Risk in Communities study). Am J. Cardiol. 2008; 101:1016–22. https://doi.org/10.1016/j.amjcard.2007.11.061
  17. Population health of the Republic of Kazakhstan and the activities of healthcare organizations in 2022: Stat. Astana; 2023. 340 p. https://www.gov.kz/memleket/entities/dsm/documents/details/583047?lang=ru
  18. Wang TJ, Larson MG, Levy D. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation. 2003; 107:2920–5. https://doi.org/10.1161/01.cir.0000072767.89944.6e
  19. Maisel WH, Stevenson LW. Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. Am J Cardiol. 2003; 91:2D–8D. https://doi.org/10.1016/s0002-9149(02)03373-8
  20. Chugh SS, Roth GA, Gillum RF. Global Burden of Atrial Fibrillation in Developed and Developing Nations. Glob Heart. 2014; 9(1):113–9. https://doi.org/10.1016/j.gheart.2014.01.004
  21. Roth GA, Mensah GA, Johnson CO. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020; 76(25):2982–3021. https://doi.org/10.1016/j.jacc.2020.11.021
  22. Healey JS, Oldgren J, Ezekowitz M. Occurrence of death and stroke in patients in 47 countries 1 year after presenting with atrial fibrillation: a cohort study. Lancet. 2016; 388(10050):1161–9. https://doi.org/10.1016/s0140-6736(16)30968-0
  23. Jager KJ, Kovesdy C, Langham R. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Kidney Int. 2019; 96:1048-1050. https://doi.org/10.1016/j.kint.2019.07.012
  24. Saran R, Robinson B, Abbott KC. US Renal Data System 2019 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2020; 75:A6-A. https://doi.org/10.1053/j.ajkd.2019.09.002
  25. Rhee CM, Kovesdy CP. Epidemiology: spotlight on CKD deaths-increasing mortality worldwide. Nat Rev Nephrol. 2015; 11:199-200. https://doi.org/10.1038/nrneph.2015.25
  26. Novartis Entresto® granted expanded indication in chronic heart failure by FDA. Feb 16, 2021. https://www.novartis.com/news/media-releases/novartis-entresto-granted-expanded-indication-chronic-heart-failure-fda
  27. McMurray JJ, Packer M, Desai AS. Dual angiotensin receptor and neprilysin inhibition as an alternative to angiotensin-converting enzyme inhibition in patients with chronic systolic heart failure: rationale for and design of the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial (PARADIGM-HF). Eur J Heart Fail 2013; 15:1062–73. https://doi.org/10.1093/eurjhf/hft052
  28. Ambardekar AV, Kittleson MM, Palardy M. Outcomes with ambulatory advanced heart failure from the Medical Arm of Mechanically Assisted Circulatory Support (MedaMACS) registry. J Heart Lung Transplant. 2019; 38:408–17. https://doi.org/10.1016/j.healun.2018.09.021

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