Angiotensin receptor / neprilysin inhibitors (ARNIs) : the new hope in the management of heart failure
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 9
Abstract
Heart failure (HF) represents major challenges in cardiovascular disease and despite newer therapeutic advances, mortality still remains high. Inhibition of neurohumoural pathways such as the renin angiotensin aldosterone and sympathetic nervous systems is central in the management of heart failure. LCZ696 (sacubutril/valsartan), a first-in-class angiotensin II AT1 receptor neprilysin inhibitor (ARNI), has a unique mode of action that targets both pathways. The Prospective comparison of ARNI with angiotensin convertase enzyme inhibitor (ACEI) to Determine Impact on Global Mortality and morbidity in Heart Failure trial (PARADIGM-HF) trial demonstrated that morbidity and mortality can be improved with the ARNI. This trial suggests that sacubitril/valsartan should replace an ACE inhibitor or angiotensin receptor blocker for the treatment of symptomatic patients (NYHA II–IV) with HF with reduced ejection fraction. This review will explore the background of neprilysin inhibition in management of HF, the results of the PARADIGM-HF trial and also guide how to use sacubitril/valsartan in clinical practice.
Authors and Affiliations
Soumya Patra, Rabin Chakraborty
Keywords
Related Articles
- EP ID EP615329
- DOI -
- Views 161
- Downloads 0
Is syndesmotic fixation is necessary in ankle injury, where we stand today?
Syndesmotic injury of ankle is not a very common injury. Treatment of this injury is very challenging and controversies are always there regarding the treatment and fixation methods, the time of weight bearing and remova...
Takayasus arteritis : role of imaging
Takayasu arteritis (TA) is a chronic large vessel vasculitis that affects aorta, its main branches and pulmonary arteries. The inflammatory process results in stenosis, occlusion, dilation or aneurysm formation in the ar...
Acute ischemic stroke : newer medications....our duty to provide and patients right to receive
NIHSS is a tool used to objectively quantify the impairment caused by a stroke. The NIHSS is composed of 11 itmes, each of which scores a specific ability between a 0 and a 4. The maximum possible score is 42, with the m...
Leg pain a rare presentation (osteochondroma a case report)
The important causes of leg pain are due to diseases affecting bones, joints, arterial occlusion, venous occlusion, muscle cramps, tendinitis, shin splints & compression to arteries and nerves. Here a 39 year old lady pr...
Safety and efficacy of triclosan-coated polyglactin 910 suture in prevention of surgical site infection in postpartum women : A randomized controlled trial
The objective of present study was to compare the safety and efficacy of two triclosan-coated polyglactin 910 sutures, MITSU AB and VICRYL Plus, in postpartum women. This was a prospective, multicenter, single-blinded, r...