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Current Cardiology Reports
Published in: Current Cardiology Reports 11/2016

01-11-2016 | Heart Failure (MR Mehra and E Joyce, Section Editors)

Angiotensin-Neprilysin Inhibition as a Paradigm for All?

Authors: Muthiah Vaduganathan, Akshay S. Desai

Published in: Current Cardiology Reports | Issue 11/2016

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Abstract

Composite angiotensin receptor-neprilysin inhibition (ARNi) represents a novel pharmacologic strategy for treatment of heart failure with reduced ejection fraction (HFrEF). In the PARADIGM-HF (Prospective comparison of ARNi with ACEi to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial of 8399 subjects with HFrEF, treatment with the ARNi LCZ696 (sacubitril/valsartan) was associated with statistically important reductions in cardiovascular death, all-cause mortality, and the composite of cardiovascular death or heart failure hospitalization in comparison with enalapril. These data have supported the US and European regulatory approval of sacubitril/valsartan and guideline-based recommendations for its use in the treatment of selected patients with HFrEF. In this review, we discuss the evidence supporting use of ARNi in preference to angiotensin-converting enzyme-inhibitors or angiotensin receptor blockers in patients with HFrEF and identify a strategy for selection of appropriate patients for transition to ARNi in clinical practice.
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Metadata
Title
Angiotensin-Neprilysin Inhibition as a Paradigm for All?
Authors
Muthiah Vaduganathan
Akshay S. Desai
Publication date
01-11-2016
Publisher
Springer US
Published in
Current Cardiology Reports / Issue 11/2016
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-016-0784-z

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