PIONEER-HF: a new frontier in the role of neprilysin inhibition in the management of heart failure with reduced ejection fraction

The addition of a neprilysin inhibitor to a renin –angiotensin system (RAS) antagonist, using the combination of sacubitril and valsartan, was shown to reduce morbidity and mortality in outpatients with chronic heart failure and reduced ejection fraction (HFrEF).1 In PARADIGM-HF (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure trial), sacubitril/valsartan reduced the risk of cardiovascular death or heart failure (HF) hospitalization by 20%, compared with a RAS blocker alone [the gold-standard angiotensin-converting enzyme (ACE)-inhibitor enalapril]. Consequently, international guidelines have recommended adding a neprilysin inhibitor in patients with HFrEF who remain symptomatic despite treatment with a RAS antagonist, beta-blocker, and mineralocorticoid receptor antagonist [by switching from existing ACE-inhibitor or angiotensin II receptor blocker (ARB) to sacubitril/valsartan].2 However, there remained a series of unanswered questions as to the role of sacubitril/valsartan in particular subgroups of patients: PARADIGM-HF did not recruit hospitalized patients; it required patients to be tolerant of maximal doses of both enalapril and sacubitril/valsartan during sequential single-blinded run-in periods prior to randomization; and it did not include patients who were ACE-inhibitor or ARB na ïve.
Source: Cardiovascular Research - Category: Cardiology Source Type: research

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Conclusions: In our study, we observed an under-prescription of recommended drugs for the treatment of HF. Moreover, one out of four HF patients were re-hospitalized for HF-related causes and the healthcare costs related to hospitalization accounted for the great majority of the total healthcare resource costs. PMID: 31971025 [PubMed - as supplied by publisher]
Source: Expert Review of Pharmacoeconomics and Outcomes Research - Category: Health Management Tags: Expert Rev Pharmacoecon Outcomes Res Source Type: research
Authors: Kovesdy CP, Gosmanova EO, Woods SD, Fogli JJ, Rowan CG, Hansen JL, Sauer BC Abstract Objective: Patiromer is a sodium-free, non-absorbed, potassium (K+) binder approved for the treatment of hyperkalemia (HK). Among US Veterans with HK, this retrospective, observational cohort study evaluated patiromer utilization, RAASi continuation, and K+ concentration change following patiromer initiation.Methods: Using data from the Veterans Affairs Corporate Data Warehouse, Veterans with HK (K+ ≥5.1 mmol/L) were included upon patiromer initiation (index date) during the study period (1/2016-8/2018). All patien...
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research
Source: BMJ Comments - Category: General Medicine Source Type: forums
Of conditions targeted by Hospital Readmissions Reduction Program, only heart failure mortality increased
Source: Pulmonary Medicine News - Doctors Lounge - Category: Respiratory Medicine Tags: Cardiology, Pulmonology, Critical Care, Emergency Medicine, Journal, Source Type: news
ConclusionsOur study analyzed the relationship of frailty and postoperative complications in patients with long bone fractures. Patients had increased likelihood of morbidity, independent of other comorbidities and demographic factors. The mFI may have a role as a simple, easy to use risk assessment tool in cases of orthopedic trauma.
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
By GRACE CORDOVANO PhD, BCPA Being a patient or a carepartner can be a lonely, powerless place. There’s no high powered legal or lobbying team to help support you in your or your loved one’s health care journey. There’s no PR team at your beck and call. There’s no advisory board, no executive committee, no assistants, no chatbots or AI-powered technology coming to the rescue. There’s no funding or a company sponsoring your efforts. There’s no course in how to be a professional patient or carepartner. There’s no one there in the stillness and dark of the night, when you ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Policy Patients caregivers carepartner Grace Cordovano Judy Faulkner patient advocacy Patient advocates Tommy Thompson Source Type: blogs
FRIDAY, Jan. 24, 2020 -- Patients with heart failure, but not those with acute myocardial infarction or pneumonia, have demonstrated an increase in postdischarge 30-day mortality, according to a study published online Jan. 15 in The BMJ. Rohan...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
Authors: Acar RD, Acar Ş, Doğan C, Bayram Z, Karaduman A, Uysal S, Akbal ÖY, Hakgör A, Kaymaz C, Özdemir N Abstract INTRODUCTION: The aim of this study was to explore the relationship between the tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure (TAPSE/PASP) ratio and model for end-stage liver disease (MELD) score in patients with advanced heart failure. METHODS: A total of 103 patients with advanced heart failure evaluated for candidacy for heart transplantation were included in this study. TAPSE was measured by M‑mode echocardiography and cardiac catheteri...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
Researchers from the University of Bristol and University Hospital Southampton have found that a drug used widely to treat a common eye condition has “ no benefit ” and should no longer be used. Eplerenone, which is primarily used to treat heart failure, is currently offered widely by ophthalmologists as a treatment for central serous chorioretinopathy (CSCR) based on limited clinical data.
Source: University of Bristol news - Category: Universities & Medical Training Tags: Research, Health; Faculty of Health Sciences, Faculty of Health Sciences, Bristol Medical School; Press Release Source Type: news
In conclusion, endogenous ghrelin system could be considered as a new target or treatment for metabolism disorders, cardiac diseases, neurodegenerative diseases, and tissue injuries.
Source: Peptides - Category: Biochemistry Source Type: research
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