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Vol 12, No 4 (2017)
Heart failure
Published online: 2017-06-19

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Candidate for new heart failure and reduced ejection fraction therapy — angiotensin receptor-neprilysin inhibitor (ARNI). Clinician’s guide

Anna Chuda1, Małgorzata Lelonek1
Folia Cardiologica 2017;12(4):397-404.

Abstract

The European Society of Cardiology (ESC) introduced a new class of drugs — ARNI (angiotensin receptor-neprilysin inhibitor) in patients with heart failure and reduced ejection fraction (HFrEF) (class I, level of evidence B) in the recently published guidelines for heart failure (HF), published in 2016. The only representative of ARNI is sacubitril/valsartan. Based on the results of the PARADAGIM-HF study, sacubitril/valsartan is recommended instead of angiotensin-converting enzyme inhibitors (ACEI) to further reduce the risk of death and hospitalization because of HF in outpatients with stable HFrEF, with symptomatic HF (NYHA II–IV) persist despite optimal treatment with ACEI (or angiotensin II receptor antagonists), beta-adrenolytic and mineralocorticoid receptor antagonist. The paper presents case report of first 2 patients with HFrEF who sacubitril/valsartan therapy was initiated.

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