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Sacubitril/valsartan: A practical guide.

Cândida Fonseca1, Dulce Brito2, Jorge Ferreira3

  • 1Clínica de Insuficiência Cardíaca, Serviço de Medicina III e Hospital Dia, Hospital São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.

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|January 26, 2019
PubMed
Summary
This summary is machine-generated.

Sacubitril/valsartan offers improved heart failure treatment by targeting the neurohormonal axis, outperforming traditional renin-angiotensin-aldosterone system inhibitors. This therapy is recommended for early stages of heart failure with reduced ejection fraction.

Keywords:
Guia práticoHeart failure with reduced ejection fractionInsuficiência cardíaca com fração de ejeção reduzidaPARADIGM-HFPractical guidanceSacubitril/valsartan

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Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Renin-angiotensin-aldosterone system (RAAS) inhibitors are standard for heart failure with reduced ejection fraction (HFrEF).
  • Sacubitril/valsartan offers a novel approach by inhibiting neprilysin and angiotensin receptors, aiming for superior neurohormonal balance.
  • The PARADIGM-HF trial established sacubitril/valsartan as a validated treatment option for HFrEF.

Purpose of the Study:

  • To validate sacubitril/valsartan as an effective treatment for HFrEF.
  • To compare the efficacy of sacubitril/valsartan against enalapril in managing HFrEF.
  • To provide guidance on the optimal use of sacubitril/valsartan in clinical practice.

Main Methods:

  • The study references the PARADIGM-HF trial, a robust cardiovascular clinical trial.
  • Patients with HFrEF, predominantly in NYHA class II, were included.
  • The trial compared sacubitril/valsartan to enalapril.

Main Results:

  • Sacubitril/valsartan demonstrated greater efficacy than enalapril in slowing HFrEF progression.
  • It significantly reduced the risk of worsening heart failure events, hospitalizations, and need for advanced therapies.
  • The drug is recommended for initiation in the earliest symptomatic stages of HFrEF.

Conclusions:

  • Sacubitril/valsartan represents a significant advancement in HFrEF management.
  • International guidelines strongly recommend sacubitril/valsartan for HFrEF patients.
  • This expert guide facilitates the practical application of sacubitril/valsartan in cardiology.