Tag Archives: sacubitril/valsartan

ESC President, Professor Barbara Casadei Heart failure highlights PARAGON-HF fails primary end point but benefits for some Heart failure was a key theme of this year’s congress, accounting for more than 1,000 presentations. In the first hotline session of the Congress, the keenly awaited results from PARAGON-HF (Angiotensin-Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction) were presented.1 Up to 64 million people worldwide have heart failure, and that number is rising as the population ages. Evidence-based treatment has focused on about half of these patients who have heart failure with reduced ejection fraction (<

The PARADIGM-HF (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) study is the key randomised-controlled trial that underpins the clinical use of sacubitril/valsartan, which demonstrated significantly improved clinical outcomes in patients with HFrEF, in comparison with angiotensin-converting enzyme (ACE) inhibition.1 Patients with HFrEF in the routine-care setting represent a clinically heterogeneous population, with a high incidence of comorbidities. Our first article dives deep into the PARADIGM-HF data, and presents the results of key subgroup analyses that support the use o

Introduction The PARADIGM-HF (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial demonstrated that the angiotensin receptor/neprilysin inhibitor (ARNI), sacubitril/valsartan (formerly known as LCZ696), was superior to enalapril in reducing the occurrence of adverse cardiovascular (CV) outcomes in patients with heart failure with reduced ejection fraction (≤40%; HFrEF).1,2 The trial was terminated early, on the advice of the independent safety monitoring board, on the basis of clear benefits. These included:1 a 20% relative risk reduction (4.7% absolute risk reduction [ARR

Introduction Much progress has been made over the last 30 years in the discovery of evidence-based pharmacological treatments that improve morbidity and mortality in people with heart failure with reduced left ventricular ejection fraction (HFrEF). Landmark trials first established angiotensin-converting enzyme (ACE) inhibitors as the mainstay therapy for heart failure (HF),1-3 with angiotensin II receptor blockers (ARB) subsequently demonstrating similar benefits for patients intolerant to ACE inhibitors.4 Further trials reported improved outcomes with mineralocorticoid receptor antagonists (MRA) used together with ACE inhibitors in HFrEF.5

Introduction Heart failure (HF) remains a significant problem globally.1 In the UK, the prevalence is estimated at over 500,000 individuals,2 with care representing 2% of National Health Service (NHS) resources (approximately £2.3 billion).3 A large proportion of the economic burden relates to lengthy and recurrent hospitalisations. Despite advancements, HF is still associated with a poor prognosis. The National Heart Failure Audit from England and Wales demonstrates an in-hospital mortality rate of around 9%, and a one-year mortality of just over 23%.4 Treatment for patients suffering from HF with reduced ejection fraction (HFrEF) is primar

Landmark trials in heart failure – 30 years from CONSENSUS With 2017 marking the 30th year since the publication of CONSENSUS,1 which first reported a reduction in mortality with enalapril versus placebo in patients with advanced heart failure (HF), the BCS held a dedicated session to review the seminal clinical trials and advances in chronic heart failure management in this period. Dr Rosita Zakeri (Royal Brompton Hospital, London) reviewed this session for us and spoke to the BJC afterwards. Rosita Zakeri The era of vasodilator therapy for heart failure began in the 1990s. Professor Karl Swedberg (University of Gothenberg, Sweden) began

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Sacubitril/valsartan (Entresto™, Novartis), the first angiotensin receptor blocker (ARB) and neprilysin inhibitor (NEP) combination – known as an angiotensin-receptor-neprilysin inhibitor (ARNI) – has recently been approved by the National Institute for Health and Care Excellence (NICE) in the treatment of patients with chronic heart failure.1 The guidance, largely based on results from the landmark PARADIGM- HF study,2 recommends sacubitril/valsartan as an “option” for symptomatic patients (New York Heart Association [NYHA] class II– IV) who have an ejection fraction of 35% or less and are established on a “stable dose” of an

Background Heart failure, a constellation of signs and symptoms in the presence of abnormal cardiac function, continues to represent a significant health problem within the UK, and, indeed, the wider developed world. In 2011, one in nine death certificates in the United States recorded heart failure as a contributing cause, and it was ascribed to being the direct underlying cause in 20% of cases.1 The current prevalence estimate for heart failure in the developed world is approximately 2%, which is a significant proportion of adults in industrialised society.2 Van Reit and colleagues have demonstrated from a systematic analysis of 25 study po