Congestive heart failure angiotensin receptor-neprilysin inhibitor: Difference between revisions

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{{Congestive heart failure}}
{{Congestive heart failure}}
{{CMG}}
{{CMG}}; {{AE}} {{Rim}},{{MehdiP}}


==Overview==
==Overview==
The PARADIGM-HF study evaluated the efficacy of LCZ696, a concomitant inhibitor of neprilysin and [[angiotensin]] receptor, on the rate of mortality due to cardiovascular causes and hospitalization.  Compared to [[enalapril]], [[angiotensin receptor]]-[[neprilysin]] inhibitor significantly reduced the rate of [[hospitalization]] by 21% and decreased the rate of cardiovascular and hospitalization-related deaths from 26.5% to 21.8%.  The administration of [[angiotensin receptor]]-neprilysin inhibitor reduced chronic heart failure symptoms and the associated limitation of physical activity.<ref name=NEJM>J. McMurray, M. Packer, M.D., A.S. Desai, M.D. Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure. New England Journal of Medicine. Epub ahead of print. Accessed on August 30, 2014. </ref>


==Angiotensin Receptor-Neprilysin Inhibitor==
==Angiotensin Receptor-Neprilysin Inhibitor==
The inhibition of [[neprilysin]], a neutral endopeptidase, has been associated with a decrease in vasoactive peptides among patients with [[heart failure]].  In fact, neprilysin inhibition decreases the breakdown of natriuretic peptide, [[bradykinin]], and [[adrenomedullin]] leading to an attenuation of [[sodium]] retention and [[vasoconstriction]] observed in heart failure patients.<ref name="pmid15492133">{{cite journal| author=Cruden NL, Fox KA, Ludlam CA, Johnston NR, Newby DE| title=Neutral endopeptidase inhibition augments vascular actions of bradykinin in patients treated with angiotensin-converting enzyme inhibition. | journal=Hypertension | year= 2004 | volume= 44 | issue= 6 | pages= 913-8 | pmid=15492133 | doi=10.1161/01.HYP.0000146483.78994.56 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15492133  }} </ref><ref name="pmid8869410">{{cite journal| author=Rademaker MT, Charles CJ, Espiner EA, Nicholls MG, Richards AM, Kosoglou T| title=Neutral endopeptidase inhibition: augmented atrial and brain natriuretic peptide, haemodynamic and natriuretic responses in ovine heart failure. | journal=Clin Sci (Lond) | year= 1996 | volume= 91 | issue= 3 | pages= 283-91 | pmid=8869410 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8869410  }} </ref><ref name="pmid11488772">{{cite journal| author=Wilkinson IB, McEniery CM, Bongaerts KH, MacCallum H, Webb DJ, Cockcroft JR| title=Adrenomedullin (ADM) in the human forearm vascular bed: effect of neutral endopeptidase inhibition and comparison with proadrenomedullin NH2-terminal 20 peptide (PAMP). | journal=Br J Clin Pharmacol | year= 2001 | volume= 52 | issue= 2 | pages= 159-64 | pmid=11488772 | doi= | pmc=PMC2014526 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11488772  }} </ref>
Animal studies revealed that the effect of [[neprilysin]] inhibition is further potentiated with the concomitant inhibition of the [[renin angiotensin system]] by the administration of [[ACE inhibitor]]s at the expense of an increased risk of [[angioedema]].<ref name="pmid9456286">{{cite journal| author=Rademaker MT, Charles CJ, Espiner EA, Nicholls MG, Richards AM, Kosoglou T| title=Combined neutral endopeptidase and angiotensin-converting enzyme inhibition in heart failure: role of natriuretic peptides and angiotensin II. | journal=J Cardiovasc Pharmacol | year= 1998 | volume= 31 | issue= 1 | pages= 116-25 | pmid=9456286 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9456286  }} </ref>  The PARADIGM-HF study evaluated the efficacy of LCZ696, a concomitant inhibitor of neprilysin and [[angiotensin]] receptor, on the rate of mortality due to cardiovascular causes and hospitalizations.  PARADIGM-HF randomized 8442 chronic heart failure patients with an [[ejection fraction]] inferior to 40% to either [[enalapril]] or angiotensin receptor-neprilysin inhibitor.  Compared to [[enalapril]], [[angiotensin receptor]]-[[neprilysin]] inhibitor significantly reduced the rate of [[hospitalization]] by 21% and decreased the rate of cardiovascular and hospitalization-related deaths from 26.5% to 21.8%.  The administration of [[angiotensin receptor]]-[[neprilysin]] inhibitor reduced chronic heart failure symptoms and the associated limitation of physical activity.<ref name=NEJM>J. McMurray, M. Packer, M.D., A.S. Desai, M.D. Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure. New England Journal of Medicine. Epub ahead of print. Accessed on August 30, 2014. </ref>
== 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500  }} </ref>==
====[[Renin-Angiotensin System]] Inhibition With [[ACEi]] or [[ARB]] or [[ARNi]]====
{|class="wikitable" style="width:80%"
|-
| colspan="1" style="text-align:center; background:LightGreen"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
|bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' In [[patients]] with [[HFrEF]] and [[NYHA]] class II to III [[symptoms]], the use of [[ARNi]] is recommended to reduce [[morbidity]] and [[mortality]]. <ref name="pmid25176015">{{cite journal| author=McMurray JJ, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR | display-authors=etal| title=Angiotensin-neprilysin inhibition versus enalapril in heart failure. | journal=N Engl J Med | year= 2014 | volume= 371 | issue= 11 | pages= 993-1004 | pmid=25176015 | doi=10.1056/NEJMoa1409077 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25176015  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=25659916 Review in: Evid Based Med. 2015 Apr;20(2):61]  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=25686189 Review in: Ann Intern Med. 2015 Feb 17;162(4):JC2] </ref><ref name="pmid31134724">{{cite journal| author=Wachter R, Senni M, Belohlavek J, Straburzynska-Migaj E, Witte KK, Kobalava Z | display-authors=etal| title=Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study. | journal=Eur J Heart Fail | year= 2019 | volume= 21 | issue= 8 | pages= 998-1007 | pmid=31134724 | doi=10.1002/ejhf.1498 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31134724  }} </ref><ref name="pmid30415601">{{cite journal| author=Velazquez EJ, Morrow DA, DeVore AD, Duffy CI, Ambrosy AP, McCague K | display-authors=etal| title=Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure. | journal=N Engl J Med | year= 2019 | volume= 380 | issue= 6 | pages= 539-548 | pmid=30415601 | doi=10.1056/NEJMoa1812851 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30415601  }} </ref><ref name="pmid31475296">{{cite journal| author=Desai AS, Solomon SD, Shah AM, Claggett BL, Fang JC, Izzo J | display-authors=etal| title=Effect of Sacubitril-Valsartan vs Enalapril on Aortic Stiffness in Patients With Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial. | journal=JAMA | year= 2019 | volume= 322 | issue= 11 | pages= 1077-1084 | pmid=31475296 | doi=10.1001/jama.2019.12843 | pmc=6749534 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31475296  }} </ref><ref name="pmid31240976">{{cite journal| author=Wang Y, Zhou R, Lu C, Chen Q, Xu T, Li D| title=Effects of the Angiotensin-Receptor Neprilysin Inhibitor on Cardiac Reverse Remodeling: Meta-Analysis. | journal=J Am Heart Assoc | year= 2019 | volume= 8 | issue= 13 | pages= e012272 | pmid=31240976 | doi=10.1161/JAHA.119.012272 | pmc=6662364 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31240976  }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
|-
|bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' In [[patients]] with previous or current [[symptoms]] of [[chronic]] [[HFrEF]], the use of [[ACEi]] is beneficial to reduce [[morbidity]] and [[mortality]] when the use of [[ARNi]] is not feasible.<ref name="pmid2883575">{{cite journal| author=CONSENSUS Trial Study Group| title=Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). | journal=N Engl J Med | year= 1987 | volume= 316 | issue= 23 | pages= 1429-35 | pmid=2883575 | doi=10.1056/NEJM198706043162301 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2883575  }} </ref><ref name="pmid2057034">{{cite journal| author=SOLVD Investigators. Yusuf S, Pitt B, Davis CE, Hood WB, Cohn JN| title=Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. | journal=N Engl J Med | year= 1991 | volume= 325 | issue= 5 | pages= 293-302 | pmid=2057034 | doi=10.1056/NEJM199108013250501 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2057034  }} </ref><ref name="pmid10587334">{{cite journal| author=Packer M, Poole-Wilson PA, Armstrong PW, Cleland JG, Horowitz JD, Massie BM | display-authors=etal| title=Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. ATLAS Study Group. | journal=Circulation | year= 1999 | volume= 100 | issue= 23 | pages= 2312-8 | pmid=10587334 | doi=10.1161/01.cir.100.23.2312 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10587334  }} </ref><ref name="pmid1386652">{{cite journal| author=Pfeffer MA, Braunwald E, Moyé LA, Basta L, Brown EJ, Cuddy TE | display-authors=etal| title=Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators. | journal=N Engl J Med | year= 1992 | volume= 327 | issue= 10 | pages= 669-77 | pmid=1386652 | doi=10.1056/NEJM199209033271001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1386652  }} </ref><ref name="pmid8104270">{{cite journal| author=| title=Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators. | journal=Lancet | year= 1993 | volume= 342 | issue= 8875 | pages= 821-8 | pmid=8104270 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8104270  }} </ref><ref name="pmid7477219">{{cite journal| author=Køber L, Torp-Pedersen C, Carlsen JE, Bagger H, Eliasen P, Lyngborg K | display-authors=etal| title=A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. Trandolapril Cardiac Evaluation (TRACE) Study Group. | journal=N Engl J Med | year= 1995 | volume= 333 | issue= 25 | pages= 1670-6 | pmid=7477219 | doi=10.1056/NEJM199512213332503 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7477219  }} </ref><ref name="pmid7654275">{{cite journal| author=Garg R, Yusuf S| title=Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials. | journal=JAMA | year= 1995 | volume= 273 | issue= 18 | pages= 1450-6 | pmid=7654275 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7654275  }} </ref><ref name="pmid20625347">{{cite journal| author=Woodard-Grice AV, Lucisano AC, Byrd JB, Stone ER, Simmons WH, Brown NJ| title=Sex-dependent and race-dependent association of XPNPEP2 C-2399A polymorphism with angiotensin-converting enzyme inhibitor-associated angioedema. | journal=Pharmacogenet Genomics | year= 2010 | volume= 20 | issue= 9 | pages= 532-6 | pmid=20625347 | doi=10.1097/FPC.0b013e32833d3acb | pmc=2945219 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20625347  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
|-
|bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' In [[patients]] with previous or current [[symptoms]] of [[chronic]] [[HFrEF]] who are intolerant to [[ACEi]] because of [[cough]] or [[angioedema]] and when the use of [[ARNi]] is not feasible, the use of [[ARB]] is recommended to reduce [[morbidity]] and [[mortality]]. <ref name="pmid11759645">{{cite journal| author=Cohn JN, Tognoni G, Valsartan Heart Failure Trial Investigators| title=A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. | journal=N Engl J Med | year= 2001 | volume= 345 | issue= 23 | pages= 1667-75 | pmid=11759645 | doi=10.1056/NEJMoa010713 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11759645  }} </ref><ref name="pmid14610160">{{cite journal| author=Pfeffer MA, McMurray JJ, Velazquez EJ, Rouleau JL, Køber L, Maggioni AP | display-authors=etal| title=Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both. | journal=N Engl J Med | year= 2003 | volume= 349 | issue= 20 | pages= 1893-906 | pmid=14610160 | doi=10.1056/NEJMoa032292 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14610160  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=15230551 Review in: ACP J Club. 2004 Jul-Aug;141(1):3] </ref><ref name="pmid19922995">{{cite journal| author=Konstam MA, Neaton JD, Dickstein K, Drexler H, Komajda M, Martinez FA | display-authors=etal| title=Effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure (HEAAL study): a randomised, double-blind trial. | journal=Lancet | year= 2009 | volume= 374 | issue= 9704 | pages= 1840-8 | pmid=19922995 | doi=10.1016/S0140-6736(09)61913-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19922995  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=20436124 Review in: Evid Based Med. 2010 Apr;15(2):51-2] </ref><ref name="pmid18700309">{{cite journal| author=Dominiak M| title=[Commentary to the article: ONTARGET Investigators, Yusuf S, Teo KK, Pogue J et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med 2008; 358: 1547-59]. | journal=Kardiol Pol | year= 2008 | volume= 66 | issue= 6 | pages= 705-6; discussion 707 | pmid=18700309 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18700309  }} </ref><ref name="pmid18757085">{{cite journal| author=Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (TRANSCEND) Investigators. Yusuf S, Teo K, Anderson C, Pogue J, Dyal L | display-authors=etal| title=Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial. | journal=Lancet | year= 2008 | volume= 372 | issue= 9644 | pages= 1174-83 | pmid=18757085 | doi=10.1016/S0140-6736(08)61242-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18757085  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=19238604 Review in: Ann Intern Med. 2009 Feb 17;150(4):JC2-6] </ref>  ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
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|bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' In [[patients]] with [[chronic]] [[symptomatic]] [[HFrEF]] [[NYHA]] class II or III who tolerate an [[ACEi]] or [[ARB]], replacement by an [[ARNi]] is recommended to further reduce [[morbidity]] and [[mortality]].  <ref name="pmid25176015">{{cite journal| author=McMurray JJ, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR | display-authors=etal| title=Angiotensin-neprilysin inhibition versus enalapril in heart failure. | journal=N Engl J Med | year= 2014 | volume= 371 | issue= 11 | pages= 993-1004 | pmid=25176015 | doi=10.1056/NEJMoa1409077 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25176015  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=25659916 Review in: Evid Based Med. 2015 Apr;20(2):61]  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=25686189 Review in: Ann Intern Med. 2015 Feb 17;162(4):JC2] </ref><ref name="pmid31134724">{{cite journal| author=Wachter R, Senni M, Belohlavek J, Straburzynska-Migaj E, Witte KK, Kobalava Z | display-authors=etal| title=Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study. | journal=Eur J Heart Fail | year= 2019 | volume= 21 | issue= 8 | pages= 998-1007 | pmid=31134724 | doi=10.1002/ejhf.1498 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31134724  }} </ref><ref name="pmid30415601">{{cite journal| author=Velazquez EJ, Morrow DA, DeVore AD, Duffy CI, Ambrosy AP, McCague K | display-authors=etal| title=Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure. | journal=N Engl J Med | year= 2019 | volume= 380 | issue= 6 | pages= 539-548 | pmid=30415601 | doi=10.1056/NEJMoa1812851 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30415601  }} </ref><ref name="pmid31475296">{{cite journal| author=Desai AS, Solomon SD, Shah AM, Claggett BL, Fang JC, Izzo J | display-authors=etal| title=Effect of Sacubitril-Valsartan vs Enalapril on Aortic Stiffness in Patients With Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial. | journal=JAMA | year= 2019 | volume= 322 | issue= 11 | pages= 1077-1084 | pmid=31475296 | doi=10.1001/jama.2019.12843 | pmc=6749534 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31475296  }} </ref><ref name="pmid31240976">{{cite journal| author=Wang Y, Zhou R, Lu C, Chen Q, Xu T, Li D| title=Effects of the Angiotensin-Receptor Neprilysin Inhibitor on Cardiac Reverse Remodeling: Meta-Analysis. | journal=J Am Heart Assoc | year= 2019 | volume= 8 | issue= 13 | pages= e012272 | pmid=31240976 | doi=10.1161/JAHA.119.012272 | pmc=6662364 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31240976  }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
|}
{|class="wikitable" style="width:80%"
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| colspan="1" style="text-align:center; background:"White"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class Value Statement: High Value]]
|-
|bgcolor="White"|<nowiki>"</nowiki>'''4.''' In [[patients]] with previous or current [[symptoms]] of [[chronic]] [[HFrEF]], in whom [[ARNi]] is not feasible, [[treatment]] with an [[ACEi]] or [[ARB]] provides high economic value. <ref name="pmid23433562">{{cite journal| author=Banka G, Heidenreich PA, Fonarow GC| title=Incremental cost-effectiveness of guideline-directed medical therapies for heart failure. | journal=J Am Coll Cardiol | year= 2013 | volume= 61 | issue= 13 | pages= 1440-6 | pmid=23433562 | doi=10.1016/j.jacc.2012.12.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23433562  }} </ref><ref name="pmid10516413">{{cite journal| author=Dasbach EJ, Rich MW, Segal R, Gerth WC, Carides GW, Cook JR | display-authors=etal| title=The cost-effectiveness of losartan versus captopril in patients with symptomatic heart failure. | journal=Cardiology | year= 1999 | volume= 91 | issue= 3 | pages= 189-94 | pmid=10516413 | doi=10.1159/000006908 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10516413  }} </ref><ref name="pmid12836712">{{cite journal| author=Glick H, Cook J, Kinosian B, Pitt B, Bourassa MG, Pouleur H | display-authors=etal| title=Costs and effects of enalapril therapy in patients with symptomatic heart failure: an economic analysis of the Studies of Left Ventricular Dysfunction (SOLVD) Treatment Trial. | journal=J Card Fail | year= 1995 | volume= 1 | issue= 5 | pages= 371-80 | pmid=12836712 | doi=10.1016/s1071-9164(05)80006-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12836712  }} </ref><ref name="pmid8185426">{{cite journal| author=Paul SD, Kuntz KM, Eagle KA, Weinstein MC| title=Costs and effectiveness of angiotensin converting enzyme inhibition in patients with congestive heart failure. | journal=Arch Intern Med | year= 1994 | volume= 154 | issue= 10 | pages= 1143-9 | pmid=8185426 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8185426  }} </ref><ref name="pmid15215801">{{cite journal| author=Reed SD, Friedman JY, Velazquez EJ, Gnanasakthy A, Califf RM, Schulman KA| title=Multinational economic evaluation of valsartan in patients with chronic heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT). | journal=Am Heart J | year= 2004 | volume= 148 | issue= 1 | pages= 122-8 | pmid=15215801 | doi=10.1016/j.ahj.2003.12.040 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15215801  }} </ref><ref name="pmid14571595">{{cite journal| author=Shekelle P, Morton S, Atkinson S, Suttorp M, Tu W, Heidenreich P | display-authors=etal| title=Pharmacologic management of heart failure and left ventricular systolic dysfunction: effect in female, black, and diabetic patients, and cost-effectiveness. | journal=Evid Rep Technol Assess (Summ) | year= 2003 | volume=  | issue= 82 | pages= 1-6 | pmid=14571595 | doi= | pmc=4781559 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14571595  }} </ref><ref name="pmid7560617">{{cite journal| author=Tsevat J, Duke D, Goldman L, Pfeffer MA, Lamas GA, Soukup JR | display-authors=etal| title=Cost-effectiveness of captopril therapy after myocardial infarction. | journal=J Am Coll Cardiol | year= 1995 | volume= 26 | issue= 4 | pages= 914-9 | pmid=7560617 | doi=10.1016/0735-1097(95)00284-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7560617  }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
|-
|bgcolor="White"|<nowiki>"</nowiki>'''6.''' In [[patients]] with [[chronic]] [[symptomatic]] [[HFrEF]], [[treatment]] with an [[ARNi]] instead of an [[ACEi]] provides high economic value. <ref name="pmid27438344">{{cite journal| author=Gaziano TA, Fonarow GC, Claggett B, Chan WW, Deschaseaux-Voinet C, Turner SJ | display-authors=etal| title=Cost-effectiveness Analysis of Sacubitril/Valsartan vs Enalapril in Patients With Heart Failure and Reduced Ejection Fraction. | journal=JAMA Cardiol | year= 2016 | volume= 1 | issue= 6 | pages= 666-72 | pmid=27438344 | doi=10.1001/jamacardio.2016.1747 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27438344  }} </ref><ref name="pmid32785628">{{cite journal| author=Gaziano TA, Fonarow GC, Velazquez EJ, Morrow DA, Braunwald E, Solomon SD| title=Cost-effectiveness of Sacubitril-Valsartan in Hospitalized Patients Who Have Heart Failure With Reduced Ejection Fraction. | journal=JAMA Cardiol | year= 2020 | volume= 5 | issue= 11 | pages= 1236-1244 | pmid=32785628 | doi=10.1001/jamacardio.2020.2822 | pmc=7675099 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32785628  }} </ref><ref name="pmid27039128">{{cite journal| author=King JB, Shah RU, Bress AP, Nelson RE, Bellows BK| title=Cost-Effectiveness of Sacubitril-Valsartan Combination Therapy Compared With Enalapril for the Treatment of Heart Failure With Reduced Ejection Fraction. | journal=JACC Heart Fail | year= 2016 | volume= 4 | issue= 5 | pages= 392-402 | pmid=27039128 | doi=10.1016/j.jchf.2016.02.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27039128  }} </ref><ref name="pmid27571284">{{cite journal| author=Sandhu AT, Ollendorf DA, Chapman RH, Pearson SD, Heidenreich PA| title=Cost-Effectiveness of Sacubitril-Valsartan in Patients With Heart Failure With Reduced Ejection Fraction. | journal=Ann Intern Med | year= 2016 | volume= 165 | issue= 10 | pages= 681-689 | pmid=27571284 | doi=10.7326/M16-0057 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27571284  }} </ref>  ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
|}
{|class="wikitable" style="width:80%"
|-
|colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''7.''' [[ARNi]] should not be administered concomitantly with [[ACEi]] or within 36 hours of the last [[dose]] of an [[ACEi]]. <ref name="pmid12186794">{{cite journal| author=Packer M, Califf RM, Konstam MA, Krum H, McMurray JJ, Rouleau JL | display-authors=etal| title=Comparison of omapatrilat and enalapril in patients with chronic heart failure: the Omapatrilat Versus Enalapril Randomized Trial of Utility in Reducing Events (OVERTURE). | journal=Circulation | year= 2002 | volume= 106 | issue= 8 | pages= 920-6 | pmid=12186794 | doi=10.1161/01.cir.0000029801.86489.50 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12186794  }} </ref><ref name="pmid14751650">{{cite journal| author=Kostis JB, Packer M, Black HR, Schmieder R, Henry D, Levy E| title=Omapatrilat and enalapril in patients with hypertension: the Omapatrilat Cardiovascular Treatment vs. Enalapril (OCTAVE) trial. | journal=Am J Hypertens | year= 2004 | volume= 17 | issue= 2 | pages= 103-11 | pmid=14751650 | doi=10.1016/j.amjhyper.2003.09.014 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14751650  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''8.''' [[ARNi]] should not be administered to [[patients]] with any [[history]] of [[angioedema]].<ref name="pmid25306450">{{cite journal| author=Vardeny O, Miller R, Solomon SD| title=Combined neprilysin and renin-angiotensin system inhibition for the treatment of heart failure. | journal=JACC Heart Fail | year= 2014 | volume= 2 | issue= 6 | pages= 663-70 | pmid=25306450 | doi=10.1016/j.jchf.2014.09.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25306450  }} </ref><ref name="pmid10968427">{{cite journal| author=Messerli FH, Nussberger J| title=Vasopeptidase inhibition and angio-oedema. | journal=Lancet | year= 2000 | volume= 356 | issue= 9230 | pages= 608-9 | pmid=10968427 | doi=10.1016/S0140-6736(00)02596-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10968427  }} </ref><ref name="pmid25766951">{{cite journal| author=Braunwald E| title=The path to an angiotensin receptor antagonist-neprilysin inhibitor in the treatment of heart failure. | journal=J Am Coll Cardiol | year= 2015 | volume= 65 | issue= 10 | pages= 1029-41 | pmid=25766951 | doi=10.1016/j.jacc.2015.01.033 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25766951  }} </ref><ref name="pmid20236700">{{cite journal| author=Ruilope LM, Dukat A, Böhm M, Lacourcière Y, Gong J, Lefkowitz MP| title=Blood-pressure reduction with LCZ696, a novel dual-acting inhibitor of the angiotensin II receptor and neprilysin: a randomised, double-blind, placebo-controlled, active comparator study. | journal=Lancet | year= 2010 | volume= 375 | issue= 9722 | pages= 1255-66 | pmid=20236700 | doi=10.1016/S0140-6736(09)61966-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20236700  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki>
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''9.''' [[ACEi]] should not be administered to [[patients]] with any [[history]] of [[angioedema]]. <ref name="pmid17085287">{{cite journal| author=Byrd JB, Adam A, Brown NJ| title=Angiotensin-converting enzyme inhibitor-associated angioedema. | journal=Immunol Allergy Clin North Am | year= 2006 | volume= 26 | issue= 4 | pages= 725-37 | pmid=17085287 | doi=10.1016/j.iac.2006.08.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17085287  }} </ref><ref name="pmid23147456">{{cite journal| author=Toh S, Reichman ME, Houstoun M, Ross Southworth M, Ding X, Hernandez AF | display-authors=etal| title=Comparative risk for angioedema associated with the use of drugs that target the renin-angiotensin-aldosterone system. | journal=Arch Intern Med | year= 2012 | volume= 172 | issue= 20 | pages= 1582-9 | pmid=23147456 | doi=10.1001/2013.jamainternmed.34 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23147456  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=23635842 Review in: Evid Based Med. 2013 Dec;18(6):e52] </ref><ref name="pmid22521308">{{cite journal| author=Makani H, Messerli FH, Romero J, Wever-Pinzon O, Korniyenko A, Berrios RS | display-authors=etal| title=Meta-analysis of randomized trials of angioedema as an adverse event of renin-angiotensin system inhibitors. | journal=Am J Cardiol | year= 2012 | volume= 110 | issue= 3 | pages= 383-91 | pmid=22521308 | doi=10.1016/j.amjcard.2012.03.034 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22521308  }} </ref><ref name="pmid30618189">{{cite journal| author=Rasmussen ER, Pottegård A, Bygum A, von Buchwald C, Homøe P, Hallas J| title=Angiotensin II receptor blockers are safe in patients with prior angioedema related to angiotensin-converting enzyme inhibitors - a nationwide registry-based cohort study. | journal=J Intern Med | year= 2019 | volume= 285 | issue= 5 | pages= 553-561 | pmid=30618189 | doi=10.1111/joim.12867 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30618189  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki>
|}
==External Link==
*[https://www.ahajournals.org/doi/epub/10.1161/CIR.0000000000001063.full.pdf 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines]<ref name="pmid35363499">{{cite journal |vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW |title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines |journal=Circulation |volume=145 |issue=18 |pages=e895–e1032 |date=May 2022 |pmid=35363499 |doi=10.1161/CIR.0000000000001063 |url=}} </ref>


==References==
==References==
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Latest revision as of 21:20, 22 June 2022
Resident
Survival
Guide
Congestive Heart Failure Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Systolic Dysfunction
Diastolic Dysfunction
HFpEF
HFrEF

Causes

Differentiating Congestive heart failure from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Clinical Assessment

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Cardiac MRI

Echocardiography

Exercise Stress Test

Myocardial Viability Studies

Cardiac Catheterization

Other Imaging Studies

Other Diagnostic Studies

Treatment

Invasive Hemodynamic Monitoring

Medical Therapy:

Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
Diuretics
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Nitrates
Hydralazine
Positive Inotropics
Anticoagulants
Angiotensin Receptor-Neprilysin Inhibitor
Antiarrhythmic Drugs
Nutritional Supplements
Hormonal Therapies
Drugs to Avoid
Drug Interactions
Treatment of underlying causes
Associated conditions

Exercise Training

Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

Congestive heart failure angiotensin receptor-neprilysin inhibitor On the Web

Most recent articles

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Ongoing Trials at Clinical Trials.gov

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Risk calculators and risk factors for Congestive heart failure angiotensin receptor-neprilysin inhibitor

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2],Seyedmahdi Pahlavani, M.D. [3]

Overview

The PARADIGM-HF study evaluated the efficacy of LCZ696, a concomitant inhibitor of neprilysin and angiotensin receptor, on the rate of mortality due to cardiovascular causes and hospitalization. Compared to enalapril, angiotensin receptor-neprilysin inhibitor significantly reduced the rate of hospitalization by 21% and decreased the rate of cardiovascular and hospitalization-related deaths from 26.5% to 21.8%. The administration of angiotensin receptor-neprilysin inhibitor reduced chronic heart failure symptoms and the associated limitation of physical activity.[1]

Angiotensin Receptor-Neprilysin Inhibitor

The inhibition of neprilysin, a neutral endopeptidase, has been associated with a decrease in vasoactive peptides among patients with heart failure. In fact, neprilysin inhibition decreases the breakdown of natriuretic peptide, bradykinin, and adrenomedullin leading to an attenuation of sodium retention and vasoconstriction observed in heart failure patients.[2][3][4]

Animal studies revealed that the effect of neprilysin inhibition is further potentiated with the concomitant inhibition of the renin angiotensin system by the administration of ACE inhibitors at the expense of an increased risk of angioedema.[5] The PARADIGM-HF study evaluated the efficacy of LCZ696, a concomitant inhibitor of neprilysin and angiotensin receptor, on the rate of mortality due to cardiovascular causes and hospitalizations. PARADIGM-HF randomized 8442 chronic heart failure patients with an ejection fraction inferior to 40% to either enalapril or angiotensin receptor-neprilysin inhibitor. Compared to enalapril, angiotensin receptor-neprilysin inhibitor significantly reduced the rate of hospitalization by 21% and decreased the rate of cardiovascular and hospitalization-related deaths from 26.5% to 21.8%. The administration of angiotensin receptor-neprilysin inhibitor reduced chronic heart failure symptoms and the associated limitation of physical activity.[1]

2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [6]

Renin-Angiotensin System Inhibition With ACEi or ARB or ARNi

Class I
"1. In patients with HFrEF and NYHA class II to III symptoms, the use of ARNi is recommended to reduce morbidity and mortality. [7][8][9][10][11](Level of Evidence: A) "
"2. In patients with previous or current symptoms of chronic HFrEF, the use of ACEi is beneficial to reduce morbidity and mortality when the use of ARNi is not feasible.[12][13][14][15][16][17][18][19] (Level of Evidence: A) "
"3. In patients with previous or current symptoms of chronic HFrEF who are intolerant to ACEi because of cough or angioedema and when the use of ARNi is not feasible, the use of ARB is recommended to reduce morbidity and mortality. [20][21][22][23][24] (Level of Evidence: A) "
"5. In patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACEi or ARB, replacement by an ARNi is recommended to further reduce morbidity and mortality. [7][8][9][10][11](Level of Evidence: B-R) "
Class Value Statement: High Value
"4. In patients with previous or current symptoms of chronic HFrEF, in whom ARNi is not feasible, treatment with an ACEi or ARB provides high economic value. [25][26][27][28][29][30][31](Level of Evidence: A) "
"6. In patients with chronic symptomatic HFrEF, treatment with an ARNi instead of an ACEi provides high economic value. [32][33][34][35] (Level of Evidence: A) "
Class III (Harm)
"7. ARNi should not be administered concomitantly with ACEi or within 36 hours of the last dose of an ACEi. [36][37] (Level of Evidence: B-R) "
"8. ARNi should not be administered to patients with any history of angioedema.[38][39][40][41] (Level of Evidence: C-LD) "
"9. ACEi should not be administered to patients with any history of angioedema. [42][43][44][45] (Level of Evidence: C-LD) "

External Link

References

  1. ↑ 1.0 1.1 J. McMurray, M. Packer, M.D., A.S. Desai, M.D. Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure. New England Journal of Medicine. Epub ahead of print. Accessed on August 30, 2014.
  2. ↑ Cruden NL, Fox KA, Ludlam CA, Johnston NR, Newby DE (2004). "Neutral endopeptidase inhibition augments vascular actions of bradykinin in patients treated with angiotensin-converting enzyme inhibition". Hypertension. 44 (6): 913–8. doi:10.1161/01.HYP.0000146483.78994.56. PMID 15492133.
  3. ↑ Rademaker MT, Charles CJ, Espiner EA, Nicholls MG, Richards AM, Kosoglou T (1996). "Neutral endopeptidase inhibition: augmented atrial and brain natriuretic peptide, haemodynamic and natriuretic responses in ovine heart failure". Clin Sci (Lond). 91 (3): 283–91. PMID 8869410.
  4. ↑ Wilkinson IB, McEniery CM, Bongaerts KH, MacCallum H, Webb DJ, Cockcroft JR (2001). "Adrenomedullin (ADM) in the human forearm vascular bed: effect of neutral endopeptidase inhibition and comparison with proadrenomedullin NH2-terminal 20 peptide (PAMP)". Br J Clin Pharmacol. 52 (2): 159–64. PMC 2014526. PMID 11488772.
  5. ↑ Rademaker MT, Charles CJ, Espiner EA, Nicholls MG, Richards AM, Kosoglou T (1998). "Combined neutral endopeptidase and angiotensin-converting enzyme inhibition in heart failure: role of natriuretic peptides and angiotensin II". J Cardiovasc Pharmacol. 31 (1): 116–25. PMID 9456286.
  6. ↑ Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check |pmid= value (help).
  7. ↑ 7.0 7.1 McMurray JJ, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR; et al. (2014). "Angiotensin-neprilysin inhibition versus enalapril in heart failure". N Engl J Med. 371 (11): 993–1004. doi:10.1056/NEJMoa1409077. PMID 25176015. Review in: Evid Based Med. 2015 Apr;20(2):61 Review in: Ann Intern Med. 2015 Feb 17;162(4):JC2
  8. ↑ 8.0 8.1 Wachter R, Senni M, Belohlavek J, Straburzynska-Migaj E, Witte KK, Kobalava Z; et al. (2019). "Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study". Eur J Heart Fail. 21 (8): 998–1007. doi:10.1002/ejhf.1498. PMID 31134724.
  9. ↑ 9.0 9.1 Velazquez EJ, Morrow DA, DeVore AD, Duffy CI, Ambrosy AP, McCague K; et al. (2019). "Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure". N Engl J Med. 380 (6): 539–548. doi:10.1056/NEJMoa1812851. PMID 30415601.
  10. ↑ 10.0 10.1 Desai AS, Solomon SD, Shah AM, Claggett BL, Fang JC, Izzo J; et al. (2019). "Effect of Sacubitril-Valsartan vs Enalapril on Aortic Stiffness in Patients With Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial". JAMA. 322 (11): 1077–1084. doi:10.1001/jama.2019.12843. PMC 6749534 Check |pmc= value (help). PMID 31475296.
  11. ↑ 11.0 11.1 Wang Y, Zhou R, Lu C, Chen Q, Xu T, Li D (2019). "Effects of the Angiotensin-Receptor Neprilysin Inhibitor on Cardiac Reverse Remodeling: Meta-Analysis". J Am Heart Assoc. 8 (13): e012272. doi:10.1161/JAHA.119.012272. PMC 6662364 Check |pmc= value (help). PMID 31240976.
  12. ↑ CONSENSUS Trial Study Group (1987). "Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS)". N Engl J Med. 316 (23): 1429–35. doi:10.1056/NEJM198706043162301. PMID 2883575.
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  14. ↑ Packer M, Poole-Wilson PA, Armstrong PW, Cleland JG, Horowitz JD, Massie BM; et al. (1999). "Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. ATLAS Study Group". Circulation. 100 (23): 2312–8. doi:10.1161/01.cir.100.23.2312. PMID 10587334.
  15. ↑ Pfeffer MA, Braunwald E, Moyé LA, Basta L, Brown EJ, Cuddy TE; et al. (1992). "Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators". N Engl J Med. 327 (10): 669–77. doi:10.1056/NEJM199209033271001. PMID 1386652.
  16. ↑ "Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators". Lancet. 342 (8875): 821–8. 1993. PMID 8104270.
  17. ↑ Køber L, Torp-Pedersen C, Carlsen JE, Bagger H, Eliasen P, Lyngborg K; et al. (1995). "A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. Trandolapril Cardiac Evaluation (TRACE) Study Group". N Engl J Med. 333 (25): 1670–6. doi:10.1056/NEJM199512213332503. PMID 7477219.
  18. ↑ Garg R, Yusuf S (1995). "Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials". JAMA. 273 (18): 1450–6. PMID 7654275.
  19. ↑ Woodard-Grice AV, Lucisano AC, Byrd JB, Stone ER, Simmons WH, Brown NJ (2010). "Sex-dependent and race-dependent association of XPNPEP2 C-2399A polymorphism with angiotensin-converting enzyme inhibitor-associated angioedema". Pharmacogenet Genomics. 20 (9): 532–6. doi:10.1097/FPC.0b013e32833d3acb. PMC 2945219. PMID 20625347.
  20. ↑ Cohn JN, Tognoni G, Valsartan Heart Failure Trial Investigators (2001). "A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure". N Engl J Med. 345 (23): 1667–75. doi:10.1056/NEJMoa010713. PMID 11759645.
  21. ↑ Pfeffer MA, McMurray JJ, Velazquez EJ, Rouleau JL, Køber L, Maggioni AP; et al. (2003). "Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both". N Engl J Med. 349 (20): 1893–906. doi:10.1056/NEJMoa032292. PMID 14610160. Review in: ACP J Club. 2004 Jul-Aug;141(1):3
  22. ↑ Konstam MA, Neaton JD, Dickstein K, Drexler H, Komajda M, Martinez FA; et al. (2009). "Effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure (HEAAL study): a randomised, double-blind trial". Lancet. 374 (9704): 1840–8. doi:10.1016/S0140-6736(09)61913-9. PMID 19922995. Review in: Evid Based Med. 2010 Apr;15(2):51-2
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  24. ↑ Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (TRANSCEND) Investigators. Yusuf S, Teo K, Anderson C, Pogue J, Dyal L; et al. (2008). "Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial". Lancet. 372 (9644): 1174–83. doi:10.1016/S0140-6736(08)61242-8. PMID 18757085. Review in: Ann Intern Med. 2009 Feb 17;150(4):JC2-6
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  29. ↑ Reed SD, Friedman JY, Velazquez EJ, Gnanasakthy A, Califf RM, Schulman KA (2004). "Multinational economic evaluation of valsartan in patients with chronic heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT)". Am Heart J. 148 (1): 122–8. doi:10.1016/j.ahj.2003.12.040. PMID 15215801.
  30. ↑ Shekelle P, Morton S, Atkinson S, Suttorp M, Tu W, Heidenreich P; et al. (2003). "Pharmacologic management of heart failure and left ventricular systolic dysfunction: effect in female, black, and diabetic patients, and cost-effectiveness". Evid Rep Technol Assess (Summ) (82): 1–6. PMC 4781559. PMID 14571595.
  31. ↑ Tsevat J, Duke D, Goldman L, Pfeffer MA, Lamas GA, Soukup JR; et al. (1995). "Cost-effectiveness of captopril therapy after myocardial infarction". J Am Coll Cardiol. 26 (4): 914–9. doi:10.1016/0735-1097(95)00284-1. PMID 7560617.
  32. ↑ Gaziano TA, Fonarow GC, Claggett B, Chan WW, Deschaseaux-Voinet C, Turner SJ; et al. (2016). "Cost-effectiveness Analysis of Sacubitril/Valsartan vs Enalapril in Patients With Heart Failure and Reduced Ejection Fraction". JAMA Cardiol. 1 (6): 666–72. doi:10.1001/jamacardio.2016.1747. PMID 27438344.
  33. ↑ Gaziano TA, Fonarow GC, Velazquez EJ, Morrow DA, Braunwald E, Solomon SD (2020). "Cost-effectiveness of Sacubitril-Valsartan in Hospitalized Patients Who Have Heart Failure With Reduced Ejection Fraction". JAMA Cardiol. 5 (11): 1236–1244. doi:10.1001/jamacardio.2020.2822. PMC 7675099 Check |pmc= value (help). PMID 32785628 Check |pmid= value (help).
  34. ↑ King JB, Shah RU, Bress AP, Nelson RE, Bellows BK (2016). "Cost-Effectiveness of Sacubitril-Valsartan Combination Therapy Compared With Enalapril for the Treatment of Heart Failure With Reduced Ejection Fraction". JACC Heart Fail. 4 (5): 392–402. doi:10.1016/j.jchf.2016.02.007. PMID 27039128.
  35. ↑ Sandhu AT, Ollendorf DA, Chapman RH, Pearson SD, Heidenreich PA (2016). "Cost-Effectiveness of Sacubitril-Valsartan in Patients With Heart Failure With Reduced Ejection Fraction". Ann Intern Med. 165 (10): 681–689. doi:10.7326/M16-0057. PMID 27571284.
  36. ↑ Packer M, Califf RM, Konstam MA, Krum H, McMurray JJ, Rouleau JL; et al. (2002). "Comparison of omapatrilat and enalapril in patients with chronic heart failure: the Omapatrilat Versus Enalapril Randomized Trial of Utility in Reducing Events (OVERTURE)". Circulation. 106 (8): 920–6. doi:10.1161/01.cir.0000029801.86489.50. PMID 12186794.
  37. ↑ Kostis JB, Packer M, Black HR, Schmieder R, Henry D, Levy E (2004). "Omapatrilat and enalapril in patients with hypertension: the Omapatrilat Cardiovascular Treatment vs. Enalapril (OCTAVE) trial". Am J Hypertens. 17 (2): 103–11. doi:10.1016/j.amjhyper.2003.09.014. PMID 14751650.
  38. ↑ Vardeny O, Miller R, Solomon SD (2014). "Combined neprilysin and renin-angiotensin system inhibition for the treatment of heart failure". JACC Heart Fail. 2 (6): 663–70. doi:10.1016/j.jchf.2014.09.001. PMID 25306450.
  39. ↑ Messerli FH, Nussberger J (2000). "Vasopeptidase inhibition and angio-oedema". Lancet. 356 (9230): 608–9. doi:10.1016/S0140-6736(00)02596-4. PMID 10968427.
  40. ↑ Braunwald E (2015). "The path to an angiotensin receptor antagonist-neprilysin inhibitor in the treatment of heart failure". J Am Coll Cardiol. 65 (10): 1029–41. doi:10.1016/j.jacc.2015.01.033. PMID 25766951.
  41. ↑ Ruilope LM, Dukat A, Böhm M, Lacourcière Y, Gong J, Lefkowitz MP (2010). "Blood-pressure reduction with LCZ696, a novel dual-acting inhibitor of the angiotensin II receptor and neprilysin: a randomised, double-blind, placebo-controlled, active comparator study". Lancet. 375 (9722): 1255–66. doi:10.1016/S0140-6736(09)61966-8. PMID 20236700.
  42. ↑ Byrd JB, Adam A, Brown NJ (2006). "Angiotensin-converting enzyme inhibitor-associated angioedema". Immunol Allergy Clin North Am. 26 (4): 725–37. doi:10.1016/j.iac.2006.08.001. PMID 17085287.
  43. ↑ Toh S, Reichman ME, Houstoun M, Ross Southworth M, Ding X, Hernandez AF; et al. (2012). "Comparative risk for angioedema associated with the use of drugs that target the renin-angiotensin-aldosterone system". Arch Intern Med. 172 (20): 1582–9. doi:10.1001/2013.jamainternmed.34. PMID 23147456. Review in: Evid Based Med. 2013 Dec;18(6):e52
  44. ↑ Makani H, Messerli FH, Romero J, Wever-Pinzon O, Korniyenko A, Berrios RS; et al. (2012). "Meta-analysis of randomized trials of angioedema as an adverse event of renin-angiotensin system inhibitors". Am J Cardiol. 110 (3): 383–91. doi:10.1016/j.amjcard.2012.03.034. PMID 22521308.
  45. ↑ Rasmussen ER, Pottegård A, Bygum A, von Buchwald C, Homøe P, Hallas J (2019). "Angiotensin II receptor blockers are safe in patients with prior angioedema related to angiotensin-converting enzyme inhibitors - a nationwide registry-based cohort study". J Intern Med. 285 (5): 553–561. doi:10.1111/joim.12867. PMID 30618189.
  46. ↑ Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW (May 2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e895–e1032. doi:10.1161/CIR.0000000000001063. PMID 35363499 Check |pmid= value (help).

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