Factors Influencing the Efficacy of Sacubitril/Valsartan in Elderly Patients with Chronic Heart Failure and Construction of Predictive Model

ZHANG Kaizhong; TAN Qin; CHEN Lijuan

doi:10.12102/j.issn.1672-1349.2025.19.018

Abstract：Objective: To investigate the factors influencing the efficacy of sacubitril/valsartan in elderly patients with chronic heart failure and to construct a predictive model. Methods: A retrospective analysis was conducted on the clinical data of 1,000 elderly patients with chronic heart failure who received sacubitril/valsartan treatment at Fenyu County People's Hospital from January 2022 to January 2024. The patients were divided into an effective group (810 cases) and an ineffective group (190 cases) based on their therapeutic outcomes after 8 weeks. Binary logistic regression analysis was used to identify the factors influencing the efficacy of sacubitril/valsartan in elderly patients with chronic heart failure. The predictive value of the model was evaluated using the receiver operating characteristic (ROC) curve. Results: Multivariate logistic regression analysis showed that age (>70 years), heart function classification (III-IV class), comorbid hypertension, malnutrition, left ventricular ejection fraction (≤35%), anxiety, depression, and red blood cell distribution width (RDW) were independent factors influencing the efficacy of sacubitril/valsartan in elderly patients with chronic heart failure (P < 0.05). ROC curve analysis showed that the areas under the curve (AUC) for age, heart function classification, comorbid hypertension, malnutrition, left ventricular ejection fraction, anxiety, depression, RDW, and the predictive model were 0.642, 0.700, 0.642, 0.614, 0.631, 0.595, 0.579, 0.686, and 0.883, respectively. Conclusion: Age (>70 years), heart function classification (III-IV class), comorbid hypertension, malnutrition, left ventricular ejection fraction (≤35%), anxiety, depression, and RDW are independent factors influencing the efficacy of sacubitril/valsartan in elderly patients with chronic heart failure. The predictive model constructed based on these factors has a high accuracy in predicting the efficacy of sacubitril/valsartan in elderly patients with chronic heart failure.