1. Angiotensin receptor-neprilysin inhibitors: A new paradigm in heart failure with reduced ejection fraction.
- Author
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Docherty, Kieran F. and McMurray, John J.V.
- Subjects
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ACE inhibitors , *HEART failure , *NATRIURETIC peptides , *ANGIOTENSINS - Abstract
Abstract Despite significant advances in the last 30 years in reducing morbidity and mortality from heart failure with reduced ejection fraction (HFrEF) with pharmacological and device-based therapies, patients remain at a high risk of adverse cardiovascular outcomes. Sacubitril/valsartan, a first-in-class angiotensin receptor-neprilysin inhibitors (ARNI), has been shown to reduce the risk of cardiovascular death or heart failure hospitalisation and improve symptoms in patients with chronic, ambulatory, symptomatic HFrEF in a large, phase 3, multicentre, international, randomised controlled trial, PARADIGM-HF, when compared to the gold-standard angiotensin converting enzyme inhibitor, enalapril. This article will review the development of sacubitril/valsartan, the evidence for its use and its current and future role in the management of HFrEF. Highlights • Natriuretic peptides have protective properties in heart failure with reduced ejection fraction. • Neprilysin degrades natriuretic peptides as well as other vasoactive peptides. • Sacubitril/valsartan is a first-in-class angiotensin receptor-neprilysin inhibitor. • Sacubitril/valsartan reduces mortality, the risk of heart failure hospitalisation and symptoms in patients with heart failure compared with the ACE-inhibitor, enalapril. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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