1. Reviewing the Modern Therapeutical Options and the Outcomes of Sacubitril/Valsartan in Heart Failure
- Author
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Diana-Carina Iovanovici, Simona Gabriela Bungau, Cosmin Mihai Vesa, Madalina Moisi, Elena Emilia Babes, Delia Mirela Tit, Tunde Horvath, Tapan Behl, and Marius Rus
- Subjects
Angiotensins ,Tetrazoles ,Catalysis ,Ventricular Function, Left ,Inorganic Chemistry ,Angiotensin Receptor Antagonists ,Enalapril ,Renin ,Humans ,Prospective Studies ,Physical and Theoretical Chemistry ,Natriuretic Peptides ,Molecular Biology ,Aldosterone ,Spectroscopy ,Heart Failure ,Aminobutyrates ,Organic Chemistry ,Biphenyl Compounds ,Stroke Volume ,General Medicine ,Computer Science Applications ,Drug Combinations ,Quality of Life ,Valsartan ,Neprilysin - Abstract
Sacubitril/valsartan (S/V) is a pharmaceutical strategy that increases natriuretic peptide levels by inhibiting neprilysin and regulating the renin-angiotensin-aldosterone pathway, blocking AT1 receptors. The data for this innovative medication are mainly based on the PARADIGM-HF study, which included heart failure with reduced ejection fraction (HFrEF)-diagnosed patients and indicated a major improvement in morbidity and mortality when S/V is administrated compared to enalapril. A large part of the observed favorable results is related to significant reverse cardiac remodeling confirmed in two prospective trials, PROVE-HF and EVALUATE-HF. Furthermore, according to a subgroup analysis from the PARAGON-HF research, S/V shows benefits in HFrEF and in many subjects having preserved ejection fraction (HFpEF), which indicated a decrease in HF hospitalizations among those with a left ventricular ejection fraction (LVEF) < 57%. This review examines the proven benefits of S/V and highlights continuing research in treating individuals with varied HF characteristics. The article analyses published data regarding both the safeness and efficacy of S/V in patients with HF, including decreases in mortality and hospitalization, increased quality of life, and reversible heart remodeling. These benefits led to the HF guidelines recommendations updating and inclusion of S/V combinations a key component of HFrEF treatment.
- Published
- 2022