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ARNI in cardiovascular disease: current evidence and future perspectives
1Department of Cardiology, Yashoda Hospitals, Somajiguda, Hyderabad, Telangana, India.
Insights
Sacubitril-valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), is a key treatment for heart failure with reduced ejection fraction (HFrEF). This review explores ARNI
Area of Science:
- Cardiology
- Pharmacology
Background:
- Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are standard treatments for cardiovascular disease and heart failure (HF).
- Sacubitril-valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), is established for treating heart failure with reduced ejection fraction (HFrEF) following the PARADIGM-HF trial.
Purpose of the Study:
- To review current literature and future perspectives on the use of ARNI in various cardiovascular disorders.
- To update on the established role of ARNI in HFrEF and its expanding applications.
Main Methods:
- Literature review of current studies on ARNI.
- Analysis of evidence from trials like PARADIGM-HF.
- Exploration of ARNI's efficacy in diverse patient subsets and conditions.
Main Results:
- The PARADIGM-HF trial established a strong evidence base for ARNI in HFrEF treatment across various patient subsets.
- ARNI is being investigated and utilized in numerous cardiovascular conditions beyond HFrEF.
Conclusions:
- ARNI, particularly sacubitril-valsartan, has a significant role in managing HFrEF.
- The therapeutic applications of ARNI are expanding to encompass a broader range of cardiovascular disorders, warranting further investigation.
Abstract:
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are the mainstay of therapy for cardiovascular disease and heart failure (HF). The angiotensin receptor II blocker - neprilysin inhibitor (ARNI), sacubitril-valsartan has an established role in treatment of patients with HF with reduced ejection fraction (HFrEF) based on the results of PARADIGM-HF trial. This trial has provided a strong evidence base for treatment of HFrEF in various subsets of patients. Several studies are done using ARNI in various indications such as HFrEF, HFrEF, patients hospitalized with acute decompensated HF, HF with preserved EF, AMI with LVEF <40%, hypertension, chronic kidney disease, pulmonary hypertension, obstructive sleep apnea, so on and so forth. This review provides an update of current literature and future perspective on ARNI in various cardiovascular disorders.
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