Publication details
Nahradí ARNI inhibitory angiotenzin konvertujícího enzymu?
| Title in English | Will ARNI replace ACE inhibitors? |
|---|---|
| Authors | |
| Year of publication | 2018 |
| Type | Article in Periodical |
| Magazine / Source | Remedia |
| MU Faculty or unit | |
| Citation | |
| Keywords | ACE inhibitors; sacubitril valsartan; PARADIGM-HF; heart Failure |
| Description | ACE inhibitors are the cornerstone for the treatment of heart Failure with decreased ejection fraction since the year 1987. Mortality was decreased by 16% in the first long-term Follow-up, known as the SOLVD study. A new drug, which has shown positive results (decrease of mortality) in patients with heart Failure is sacubitril valsartan (LCZ696) which is neprilysin inhibitor (sacubitril, AHU377) and angiotensin II receptor 1 blocker (valsartan). The mechanism of action is ATI receptor blockade in combination with the inhibition oFnatriuretic peptide degradation which leads to direct vasodilatation. The new class oFdual inhibitor is called ARNI (Angiotensin Receptor - Neprilysin Inhibitor). PARADIGM-HF clinical study in patients with decreased ejection fraction and high levels oF natriuretic peptides was prematurely terminated for a positive effect oFsacubitril valsartan when compared with enalapril. Cardiovascular mortality was decreased by 20%, first hospitalisation by 21 %. PAR AGON-HF is a study in patients with preserved ejection Fraction which is enrolling patients at present. The results oF the PARADIGM-HF study show that sacubitril valsartan may replace ACE inhibitors in the treatment oF patients with heart failure and reduced ejection fraction. |