Heart failure trials on pharmacological therapy in 2015: lessons learned and future outlook

Much progress in the medical therapy of chronic heart failure (HF) has been made in the last decades. The last was the introduction of a new treatment strategy based on the combination of the neprilysin inhibitor sacubitril and the angiotensin receptor blocker (ARB) valsartan into the pharmacological armamentarium, as reported in the PARADIGM-HF trial and its ancillary analyses. On the other hand, in the acute setting only scant progress in pharmacological treatments has been achieved, and most published data are based on observational studies or expert opinion. This review critically presents and discusses the most intriguing evidence from clinical trials in HF published in 2015. In particular, we focused on chronic HF with reduced ejection fraction and its comorbidities, while worsening HF or acute decompensated HF were more synthetically treated.