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sacubitril, valsartan

Sarah L Anderson, Joel C Marrs
Hypertension (HTN) is a common disease state associated with extensive morbidity and mortality worldwide. It is often difficult for patients with HTN to achieve and maintain a goal blood pressure (BP), despite there being many effective treatment options available. Sacubitril/valsartan is a first-in-class angiotensin receptor neprilysin inhibitor (ARNI) that has garnered approval by the US Food and Drug Administration and the European Medicines Agency as a first-line treatment for heart failure with reduced ejection fraction...
2018: Drugs in Context
Gabriela Andries, Srikanth Yandrapalli, Wilbert S Aronow
Heart failure (HF) is an important public health problem with an increasing prevalence across the globe. The mortality rates from this complex clinical problem have stabilized in the recent years with the use of pharmacotherapeutics which demonstrated survival benefits in patients with HF with reduced ejection fraction (HFrEF). Areas Covered: We reviewed the 7 classes of medications which constitute the guideline-directed medical therapy (GDMT) in chronic HF patients. We discussed clinical trials which support or contradict their use, potential adverse events, and available real-world data on utilization and safety...
August 16, 2018: Expert Opinion on Drug Safety
Zubair Khan, Gunjan Gholkar, Sunit Tolia, Herman Kado, Marcel Zughaib
BACKGROUND: Sacubitril/valsartan is the newest neurohormonal agent approved for therapy in patients with heart failure with reduced ejection fraction (HFrEF). Little is known about its acute and incremental hemodynamic effects. We aimed to evaluate the change in hemodynamic profiles measured using an implanted monitoring device in HFrEF patients initiated on sacubitril/valsartan therapy. METHODS: We prospectively enrolled 13 subjects with HFrEF and pre-implanted CardioMEMS™ device on maximally tolerated guideline-directed medical therapy and no contraindications to sacubitril/valsartan therapy...
August 6, 2018: International Journal of Cardiology
Daniel K Newhard, SeungWoo Jung, Randolph L Winter, Sue H Duran
BACKGROUND: The effects of sacubitril/valsartan (S/V) on the renin-angiotensin-aldosterone system (RAAS) in dogs with cardiomegaly secondary to myxomatous mitral valve disease (MMVD) are currently unknown. OBJECTIVES: To determine the pharmacodynamic effects of S/V on the RAAS, natriuretic peptide concentrations, systolic arterial pressure (SAP), tests of renal function, and serum electrolyte concentrations in dogs with cardiomegaly secondary to MMVD. ANIMALS: Thirteen client-owned dogs weighing 4-15 kg with American College of Veterinary Internal Medicine (ACVIM) Stage B2 MMVD...
August 7, 2018: Journal of Veterinary Internal Medicine
Brian K W Yum, William H Frishman
Heart failure (HF) patients with either reduced ejection fraction or preserved ejection fraction experience a high mortality rate. The most recent pharmacologic advance for treating patients with HF with reduced ejection fraction has been with sacubitril/valsartan. Along with pharmaceutical research, there has been interest in device-based therapies as another treatment approach. One novel interventional device therapy that has shown promise in early tests and trials is the interatrial shunt device developed by Corvia Medical Inc...
September 2018: Cardiology in Review
Carsten Tschöpe, Alessio Alogna, Frank Spillmann, Alessandro Faragli, Gunther Schmidt, Florian Blaschke, Uwe Kühl, Ewa Hertel, Monika Willner, Daniel Morris, Heiner Post, Michel Noutsias, Burkert Pieske, Florian Krackhardt
BACKGROUND: Recent clinical trials have shown that pulmonary artery pressure-guided therapy via the CardioMEMS™ system reduces the risk of recurrent hospitalizations in chronic heart failure (HF) patients. The CardioMEMS™ pressure sensor is percutaneously implanted in a branch of the pulmonary artery and allows telemetric pressure monitoring via a receiver. According to the most recent ESC guidelines, this technology has currently a class IIb indication in patients with class III New York Heart Association symptoms and a previous hospitalization for congestive heart failure within the last year, regardless of ejection fraction...
July 31, 2018: BMC Cardiovascular Disorders
Srikanth Yandrapalli, George Jolly, Medha Biswas, Yogita Rochlani, Prakash Harikrishnan, Wilbert S Aronow, Gregg M Lanier
Heart failure (HF) is characterized by maladaptive neurohormonal activation of the cardiovascular and renal systems resulting in circulatory inadequacy and frequent acute exacerbations. The increasing burden of HF prompted investigation of underlying pathophysiological mechanisms and the design of pharmacotherapeutics that would target these pathways. Areas covered: A MEDLINE search for relevant original investigations and review articles of newer hormonal drugs for HF since the year 2005 till October 2017 provided us with necessary literature...
January 2018: Expert Review of Endocrinology & Metabolism
Masanobu Ishii, Koichi Kaikita, Koji Sato, Daisuke Sueta, Koichiro Fujisue, Yuichiro Arima, Yu Oimatsu, Tatsuro Mitsuse, Yoshiro Onoue, Satoshi Araki, Megumi Yamamuro, Taishi Nakamura, Yasuhiro Izumiya, Eiichiro Yamamoto, Sunao Kojima, Shokei Kim-Mitsuyama, Hisao Ogawa, Kenichi Tsujita
LCZ696 (sacubitril/valsartan) can lower the risk of cardiovascular events in chronic heart failure. However, it is unclear whether LCZ696 can improve prognosis in patients with acute myocardial infarction (MI). The present study shows that LCZ696 can prevent cardiac rupture after MI, probably due to the suppression of pro-inflammatory cytokines, matrix metalloproteinase-9 activity and aldosterone production, and enhancement of natriuretic peptides in mice. These findings suggest the mechanistic insight of cardioprotective effects of LCZ696 against acute MI, resulting in the belief that LCZ696 might be useful clinically to improve survival after acute MI...
December 2017: JACC. Basic to Translational Science
Hans Keller, Ulrike Neuhold, Franz Weidinger, Edmund Gatterer, Claudia Stöllberger, Klaus Huber, Josef Finsterer
Background : Whether patients with subclinical cardiomyopathy (CMP) are more prone to experience Takotsubo syndrome (TTS) than patients without CMP, is unknown. We present a patient with TTS as the initial manifestation of a hitherto unrecognized genetic CMP. Method : case report. Results : At age 55 after the unexpected death of her father, a now 61-year-old female had developed precordial pressure. Work-up revealed moderately reduced systolic function, dyskinesia of the interventricular septum, and indications for a TTS...
July 30, 2018: Medicines (Basel, Switzerland)
Afschin Gandjour, Dennis A Ostwald
BACKGROUND: Heart failure affects over 1 million people in Germany and contributes to morbidity, mortality, and high healthcare costs. A recent large randomized controlled trial compared the novel compound sacubitril/valsartan (LCZ696) with the angiotensin-converting enzyme (ACE) inhibitor enalapril and found a 16% reduction in mortality hazard. In Germany, sacubitril/valsartan was launched at the beginning of 2016. OBJECTIVE: The purpose of this study was to conduct a post hoc analysis of the cost effectiveness, budget impact, and disease burden reduction of sacubitril/valsartan compared with ACE inhibitors for patients with heart failure from the perspective of the German social health insurance (SHI), based on the results of this trial...
July 27, 2018: PharmacoEconomics
Hiroyuki Tsutsui, Shin-Ichi Momomura, Yoshihiko Saito, Hiroshi Ito, Kazuhiro Yamamoto, Tomomi Ohishi, Naoko Okino, Toshihito Kitamura, Weinong Guo
BACKGROUND: The objective of the present analyses was to describe the baseline characteristics and treatment of the Japanese patients with HFrEF in THE PARALLEL-HF study.Methods and Results:Key demographic, clinical and laboratory findings, along with treatment, were reported and compared with patients enrolled in the PARADIGM-HF trial and other contemporary randomized clinical trials and registries of Japanese patients with HFrEF. In addition, the MAGGIC and EMPHASIS-HF risk scores were calculated...
July 26, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Raquel Rodil Fraile, Vincenzo Malafarina, Gregorio Tiberio López
AIMS: The poor control of symptoms in patients with advanced heart failure with reduced ejection function (HFrEF) can limit the functionality of patients. Sacubitril-valsartan, compared with enalapril, has been shown to reduce mortality and hospitalization, and nowadays, there is still little evidence about the improvement on functionality. The aim of our study is to analyse the improvement of the functional class and the 6 min walking test (6MWT) in patients with multiple pathologies and advanced heart failure...
July 24, 2018: ESC Heart Failure
Joaquim Cristino, Immanuel Tang, Caroline Ng, Jonathan Tan, David Trueman, Declan Lee
No abstract text is available yet for this article.
July 23, 2018: Journal of Medical Economics
Richard Haynes, Parminder K Judge, Natalie Staplin, William G Herrington, Benjamin C Storey, Angelyn Bethel, Louise Bowman, Nigel Brunskill, Paul Cockwell, Michael Hill, Philip A Kalra, John J V McMurray, Maarten Taal, David C Wheeler, Martin J Landray, Colin Baigent
Background -Sacubitril/valsartan reduces the risk of cardiovascular mortality among patients with heart failure with reduced ejection fraction, but its effects on kidney function and cardiac biomarkers in people with moderate-to-severe chronic kidney disease are unknown. Methods -UK HARP-III was a randomised double-blind trial which included 414 participants with an estimated glomerular filtration rate (GFR) 20-60 mL/min/1.73m2 who were randomly assigned to sacubitril/valsartan 97/103 mg twice daily versus irbesartan 300 mg once daily...
July 12, 2018: Circulation
Elena Gamarra, Claudia Baffoni, Giorgio Borretta, Mauro Feola, Francesco Tassone
No abstract text is available yet for this article.
July 1, 2018: Journal of Diabetes Science and Technology
Scott D Solomon, Adel R Rizkala, Martin P Lefkowitz, Victor C Shi, JianJian Gong, Nagesh Anavekar, Stefan D Anker, Juan L Arango, Jose L Arenas, Dan Atar, Turia Ben-Gal, Sergey A Boytsov, Chen-Huan Chen, Vijay K Chopra, John Cleland, Josep Comin-Colet, Hans-Dirk Duengen, Luis E Echeverría Correa, Gerasimos Filippatos, Andreas J Flammer, Michel Galinier, Armando Godoy, Eva Goncalvesova, Stefan Janssens, Tzvetana Katova, Lars Køber, Małgorzata Lelonek, Gerard Linssen, Lars H Lund, Eileen O'Meara, Béla Merkely, Davor Milicic, Byung-Hee Oh, Sergio V Perrone, Naresh Ranjith, Yoshihiko Saito, Jose F Saraiva, Sanjiv Shah, Petar M Seferovic, Michele Senni, Antonio S Sibulo, David Sim, Nancy K Sweitzer, Jyrki Taurio, Dragos Vinereanu, Bojan Vrtovec, Jiří Widimský, Mehmet B Yilmaz, Jingmin Zhou, Robert Zweiker, Inder S Anand, Junbo Ge, Carolyn S P Lam, Aldo P Maggioni, Felipe Martinez, Milton Packer, Marc A Pfeffer, Burkert Pieske, Margaret M Redfield, Jean L Rouleau, Dirk J Van Veldhuisen, Faiez Zannad, Michael R Zile, John J V McMurray
BACKGROUND: To describe the baseline characteristics of patients with heart failure and preserved left ventricular ejection fraction enrolled in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF) comparing sacubitril/valsartan to valsartan in reducing morbidity and mortality. METHODS AND RESULTS: We report key demographic, clinical, and laboratory findings, and baseline therapies, of 4822 patients randomized in PARAGON-HF, grouped by factors that influence criteria for study inclusion...
July 2018: Circulation. Heart Failure
Bibhuti B Das, Frank Scholl, Breanna Vandale, Maryanne Chrisant
The Prospective comparison of angiotensin receptor antagonist Valsartan and neprilysin inhibitor Sacubitril with angiotensin-converting enzyme inhibitor (enalapril) to determine impact on Global Mortality and Morbidity in Heart Failure trial has demonstrated that Sacubitril/Valsartan is superior to Enalapril in reducing the risks of both sudden cardiac death and death from worsening heart failure. This novel combination, Sacubitril/Valsartan, is also shown to reduce the risk of hospitalisation and progression of heart failure in adults...
September 2018: Cardiology in the Young
Uwe Schuehly, Surya Ayalasomayajula, Jeppe Buchbjerg, Parasar Pal, Georg Golor, Margaret F Prescott, Gangadhar Sunkara, Markus Hinder, Thomas H Langenickel
PURPOSE: Sacubitril/valsartan (LCZ696) and nitroglycerin share the second messenger cGMP and lower blood pressure. Given the potential for co-administration of both drugs in patients with heart failure, this study was designed to investigate the potential for a pharmacodynamic drug interaction affecting blood pressure. METHODS: In this double-blind, placebo-controlled, randomised, crossover study, 40 healthy subjects received sacubitril/valsartan 200 mg bid (97/103 mg bid) or placebo for 5 days...
July 4, 2018: European Journal of Clinical Pharmacology
Michael H Chiu, Jonathan G Howlett, Vikas P Kuriachan, Nakul C Sharma
A 58-year-old man with previous mitral/aortic mechanical-valve replacement, aortic root repair, and coronary disease developed severe left-ventricular dysfunction following AV-node ablation/single-chamber pacemaker implantation for management of atrial fibrillation. He then underwent an upgrade to cardiac resynchronization therapy with a defibrillator. To manage his heart failure better, angiotensin-receptor blocker therapy was changed to sacubitril/valsartan, after which symptomatic palpitations with T-wave oversensing occurred...
August 2018: Canadian Journal of Cardiology
Becky N Lu, Lindsay E Davis
The FDA has approved sacubitril/valsartan, an angiotensin-receptor-neprilysin inhibitor, for the treatment of chronic symptomatic heart failure (stage C) in patients with a left ventricular ejection fraction of 35% or less. This article discusses results from a major clinical trial, PARADIGM-HF, and the role of this new drug in heart failure treatment.
July 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
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