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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PMID: 32929710 [PubMed - in process]
Source: Cardiology Journal - Category: Cardiology Authors: Tags: Cardiol J Source Type: research
CONCLUSIONS: AD is responsible for an increasing proportion of hospitalizations in Spain and raising medical costs, which highlights the importance of early detection and optimized care. PMID: 32928002 [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
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Source: Annals of Surgery - Category: Surgery Tags: COVID PAPERS Source Type: research
Conclusions: This large matched-cohort study identified the minimum weight loss thresholds for reduction in risk of MACE and all-cause mortality in patients with obesity and diabetes. Furthermore, in our analysis, the effect of surgery was still present after accounting for weight loss, which may suggest the presence of weight-independent beneficial effects of metabolic surgery on MACE and survival.
Source: Annals of Surgery - Category: Surgery Tags: PAPERS CHOSEN FOR PRESENTATION AT THE 2020 ANNUAL MEETING OF THE AMERICAN SURGICAL ASSOCIATION Source Type: research
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Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research
Atrial fibrillation and peripheral arterial disease are two conditions associated with high risk of cardiovascular and cerebrovascular complications and mortality.1 –5 There is evidence that coexistence of both these clinical conditions can result to an additive risk of adverse events.6 Indeed, atherosclerotic vascular disease has been linked with stroke, thromboembolism and death in subjects with atrial fibrillation and has been therefore included as one of the components of risk scores, such as the CHA2DS2-VASc score (Congestive Heart failure, Hypertension Age> 75 years, DM, Stroke, Vascular disease) in order to...
Source: The American Journal of Medicine - Category: General Medicine Authors: Source Type: research
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Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Cardiology News Source Type: news
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Source: American Heart Journal - Category: Cardiology Source Type: research
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Source: American Heart Journal - Category: Cardiology Source Type: research
September 9, 2020 To:       American College of Cardiology American College of Chest Physicians American College of Physicians American College of Radiology American Heart Association American Society of Echocardiography American Thoracic Society European Association of Cardiovascular Imaging European Society of Cardiology European Society of Radiology Heart Rhythm Society Infectious Disease Society of America North American Society of Cardiovascular Imaging Radiologic Society of North America Society of Cardiovascular Magnetic Resonance Soci...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: COVID-19 Medical Practice Patients Physicians myocarditis Saurabh Jha Source Type: blogs
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