Docherty, K. F & McMurray, JJ. (2019). Angiotensin receptor-neprilysin inhibitors: A new paradigm in heart failure with reduced ejection fraction. International Journal of Cardiology,281 179-185. Ireland: Elsevier Ireland Ltd.. Retrieved from https://doi.org/10.1016/j.ijcard.2018.05.124
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.
Mary MacKillop Institute for Health Research
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