Practical guidance on the use of sacubitril/valsartan for heart failure.
Heart Fail Rev
; 24(2): 167-176, 2019 03.
Article
in En
| MEDLINE
| ID: mdl-30565021
ABSTRACT
Sacubitril/valsartan is a first-in-class angiotensin receptor-neprilysin inhibitor (ARNI) that has been recommended in clinical practice guidelines to reduce morbidity and mortality in patients with chronic, symptomatic heart failure (HF) with reduced ejection fraction (HFrEF). This review provides an overview of ARNI therapy, proposes strategies to improve the implementation of sacubitril/valsartan in clinical practice, and provides clinicians with evidence-based, practical guidance on the use of sacubitril/valsartan in patients with HFrEF. Despite evidence demonstrating the benefits of ARNI therapy over standard of care, only a fraction of eligible patients takes sacubitril/valsartan. Barriers preventing the prescription of sacubitril/valsartan in eligible patients may include practitioners' unfamiliarity with ARNIs, safety concerns, and payer reimbursement issues. The optimal implementation of sacubitril/valsartan in clinical practice has the potential to reduce the overall burden of HF. Throughout this review, we describe our experience with sacubitril/valsartan, including strategies for the management of adverse events and common patient concerns. In addition, a strategy for the gradual introduction of sacubitril/valsartan using a treatment sequence scheme is proposed.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tetrazoles
/
Angiotensin Receptor Antagonists
/
Aminobutyrates
/
Heart Failure
Type of study:
Guideline
/
Prognostic_studies
Limits:
Aged
/
Aged80
/
Humans
/
Middle aged
Language:
En
Journal:
Heart Fail Rev
Journal subject:
CARDIOLOGIA
Year:
2019
Type:
Article
Affiliation country:
United States