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Published in: Heart Failure Reviews 1/2022

01-01-2022 | Enalapril

Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper

Authors: Argyrios Ntalianis, Christina Chrysohoou, George Giannakoulas, Grigorios Giamouzis, Apostolos Karavidas, Aikaterini Naka, Constantinos H. Papadopoulos, Sotirios Patsilinakos, John Parissis, Dimitrios Tziakas, John Kanakakis

Published in: Heart Failure Reviews | Issue 1/2022

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Abstract

The short-term mortality and rehospitalization rates after admission for acute heart failure (AHF) remain high, despite the high level of adherence to contemporary practice guidelines. Observational data from non-randomized studies in AHF strongly support the in-hospital administration of oral evidence-based modifying chronic heart failure (HF) medications (i.e., b-blockers, ACE inhibitors, mineralocorticoid receptor antagonists) to reduce morbidity and mortality. Interestingly, a well-designed prospective randomized multicenter study (PIONEER-HF) showed an improved clinical outcome and stress/injury biomarker profile after in-hospital administration of sacubitril/valsartan (sac/val) as compared to enalapril, in hemodynamically stable patients with AHF. However, sac/val implementation during hospitalization remains suboptimal due to the lack of an integrated individualized plan or well-defined appropriateness criteria for transition to oral therapies, an absence of specific guidelines regarding dose selection and the up-titration process, and uncertainty regarding patient eligibility.
In the present expert consensus position paper, clinical practical recommendations are proposed, together with an action plan algorithm, to encourage and facilitate sac/val administration during hospitalization after an AHF episode with the aim of improving efficiencies of care and resource utilization.
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Metadata
Title
Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper
Authors
Argyrios Ntalianis
Christina Chrysohoou
George Giannakoulas
Grigorios Giamouzis
Apostolos Karavidas
Aikaterini Naka
Constantinos H. Papadopoulos
Sotirios Patsilinakos
John Parissis
Dimitrios Tziakas
John Kanakakis
Publication date
01-01-2022
Publisher
Springer US
Published in
Heart Failure Reviews / Issue 1/2022
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI
https://doi.org/10.1007/s10741-021-10115-8

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