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Is Entresto good for the brain?

Nirav Patel1, Jason Gluck1

  • 1Nirav Patel, Jason Gluck, Department of Cardiology, University of Connecticut, Harford Hospital, Hartford, CT 06102, United States.

World Journal of Cardiology
|August 22, 2017
PubMed

Insights

Sacubitril-valsartan (SV) improves heart failure (HF) outcomes by targeting both the renin-angiotensin-aldosterone (RAAS) and neprilysin pathways (NP). Long-term monitoring is crucial to assess potential Alzheimer

Area of Science:

  • Cardiology
  • Pharmacology
  • Neurology

Background:

  • Current heart failure (HF) pharmacotherapy targets the renin-angiotensin-aldosterone (RAAS) and neprilysin pathways (NP).
  • While effective in reducing morbidity and mortality, these therapies have notable adverse effects.
  • Sacubitril-valsartan (SV), also known as Entresto, represents a novel approach by simultaneously inhibiting both RAAS and NP.

Purpose of the Study:

  • To review the literature on the efficacy and safety of sacubitril-valsartan (SV) in heart failure management.
  • To highlight the dual-action mechanism of SV as an angiotensin receptor blocker and neprilysin inhibitor (NPi).
  • To investigate concerns regarding potential adverse effects, specifically the risk of Alzheimer's disease (AD).

Main Methods:

  • Literature review of studies on sacubitril-valsartan (SV) in heart failure.
  • Analysis of the pharmacological action of SV on RAAS and NP pathways.
  • Examination of reported side effects, including cognitive changes and Alzheimer's disease (AD) risk.

Main Results:

  • SV has demonstrated improved heart failure prognosis, marking an evolution in HF management.
  • Initial follow-up data for SV treatment shows promising results.
  • Concerns exist regarding a potential increased risk of Alzheimer's disease (AD) due to neprilysin inhibition's effect on beta-amyloid peptide clearance.

Conclusions:

  • Sacubitril-valsartan (SV) offers a significant advancement in heart failure treatment through dual pathway inhibition.
  • The potential link between neprilysin inhibition and Alzheimer's disease (AD) necessitates careful consideration.
  • Extended patient follow-up is essential to monitor for any adverse cognitive changes in individuals treated with SV.

Keywords:
Alzheimer’s diseaseEntrestoHeart failureLCZ696Neprilysin inhibitorSacubitril-valsartan

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