Dual inhibition of at1 receptor for angiotensin ii and neprilysin or sacibtril‑valsartan

Q: What is the clinical evidence from this study?

Study design: Review. Population: Heart failure with reduced ejection fraction (n=8399). Intervention: Sacubitril-valsartan vs. Enalapril 10 mg twice daily. Primary outcome: Cardiovascular death or first hospitalization for heart failure (HR 0.80, 95% CI 0.73-0.87, p=<0.001).

Q: What does this research mean for the field?

Sacubitril-valsartan reduced the composite of cardiovascular death or first hospitalization for heart failure by 20% compared to enalapril in patients with heart failure and reduced ejection fraction. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Jindřich Špinar; Lenka Špinarová; Jiří Vítovec

doi:10.36290/int.2019.044

May 10, 2019Interní medicína pro praxiOpen Access

Dual inhibition of at1 receptor for angiotensin ii and neprilysin or sacibtril‑valsartan

View Full Paper

Ask AI

Bookmark

Share

Why the study?

Does sacubitril-valsartan reduce cardiovascular mortality and heart failure hospitalizations in patients with heart failure compared to enalapril?

Structured PICO

Does sacubitril-valsartan reduce cardiovascular mortality and heart failure hospitalizations in patients with heart failure compared to enalapril?

P

Population

Patients with heart failure, primarily focusing on those with reduced ejection fraction (HFrEF) and high natriuretic peptide levels.

I

Intervention

Sacubitril-valsartan (dual inhibition of AT1 receptor and neprilysin)

C

Comparator

Enalapril or valsartan

O

Outcome

Composite of cardiovascular mortality and first hospitalization for worsening heart failurecomposite

Main Result

Effect estimate: HR 0.80 (95% CI 0.73-0.87)

Absolute Event Rate: 21.8% vs 26.5%

p-value: p=<0.001

Sacubitril-valsartan represents a significant advancement in heart failure treatment, demonstrating superiority over ACE inhibitors in reducing mortality and morbidity in HFrEF.

Limitations

Higher incidence of hypotension compared to enalapril

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Supports sacubitril-valsartan in HFrEF; leaves open need for prospective validation in broader populations.

Abstract

DuĂĄlnĂ antagonista receptorĹŻ AT1 pro angiotenzin II (ARB) a neprilysinu s generickĂ˝m nĂĄzvem sacubitril‑valsartan (dĹĂve LCZ696 nebo takĂŠ angiotenzin receptor blocker and neprilysin inhibitor – ARNI) byl klinicky ovÄĹovĂĄn pro lĂŠÄbu hypertenze a srdeÄnĂho selhĂĄnĂ. Mechanismus ĂşÄinku je v blokĂĄdÄ receptorĹŻ AT1 valsartanem v kombinaci s blokĂĄdou rozpadĹŻ vazodilataÄnĂch natriuretickĂ˝ch peptidĹŻ a tĂm intenzifikovanĂŠ vazodilatace. PrvnĂ klinickĂĄ studie PARAMOUNT s LCZ696 v lĂŠÄbÄ srdeÄnĂho selhĂĄnĂ se zachovalou ejekÄnĂ frakcĂ prokĂĄzala vĂ˝znamnĂŠ snĂĹženĂ koncentrace NT‑proBNP. KlinickĂĄ studie PARADIGM‑HF u nemocnĂ˝ch se snĂĹženou ejekÄnĂ frakcĂ a vysokĂ˝mi hodnotami natriuretickĂ˝ch peptidĹŻ byla pĹedÄasnÄ ukonÄena pro pĹĂznivĂ˝ vliv LCZ696 ve srovnĂĄnĂ s enalaprilem jak na mortalitu, tak na hospitalizace. KardiovaskulĂĄrnĂ mortalita byla snĂĹžena o 20 %, prvnĂ hospitalizace pro srdeÄnĂ selhĂĄnĂ o 21 %. ProbĂhĂĄ studie PARAGON‑HF u srdeÄnĂho selhĂĄnĂ se zachovalou ejekÄnĂ frakcĂ.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Špinar et al. (2019) conducted a review in Heart failure with reduced ejection fraction (n=8,399). Sacubitril-valsartan vs. Enalapril 10 mg twice daily was evaluated on Cardiovascular death or first hospitalization for heart failure (HR 0.80, 95% CI 0.73-0.87, p=<0.001).

synapsesocial.com/papers/6a163a3310348063628e969b https://doi.org/10.36290/int.2019.044

View Full Paper

Ask AI

Bookmark

Share

Dual inhibition of at1 receptor for angiotensin ii and neprilysin or sacibtril‑valsartan

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Dual inhibition of at1 receptor for angiotensin ii and neprilysin or sacibtril‑valsartan

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading