Why the study?
Does sacubitril/valsartan reduce cardiovascular death and heart failure hospitalization in patients with chronic heart failure with reduced ejection fraction?
Does sacubitril/valsartan reduce cardiovascular death and heart failure hospitalization in patients with chronic heart failure with reduced ejection fraction?
Sacubitril/valsartan is a novel and effective therapy that reduces cardiovascular mortality and heart failure hospitalizations in patients with HFrEF who remain symptomatic on standard optimized treatment.
Recently US Food and Drug Administration (FDA) approved valsartan/sacubitril is the first angiotensin receptor/neprilysin inhibitor (ARNI) that offers a new standard of treatment to physicians for the patients of heart failure with reduced ejection fraction. Sacubitril is a prodrug which gets activated to sacubitrilat and this inhibits the enzyme neprilysin which is a membrane bound endopeptidase and which in turn is responsible for the degradation of various natriuretic peptides. The action of Valsartan which selectively blocks the angiotensin II type-1 receptor is needed in addition to sacubitril because inhibition of neprilysin is accompanied by the activation of renin-angiotensin system. The combination appears to be a suitable alternative for patients of heart failure with persistent symptoms or with recent exacerbation or hospitalization while on standard optimized treatment. The availability of this novel sacubitril/valsartan combination is an important development in the heart failure management.
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Gupta et al. (2016) conducted a review in Heart failure with reduced ejection fraction. Sacubitril/valsartan vs. Enalapril was evaluated on Cardiovascular death or heart failure hospital admission (NNT 21).
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