Sacubitril with valsartan, a modern pharmacotherapy in heart failure - a literature review
DOI:
https://doi.org/10.12775/QS.2024.17.53117Keywords
angiotensin receptor-neprilysin inhibitor, arni, heart failure, pharmacotherapy, sacubitril, valsartanAbstract
Introduction and purpose: Heart failure is one of the most common cardiovascular diseases worldwide. It is an important factor leading to a reduced, health-related quality of life (HRQoL) not only because of its various symptoms but also due to loss of jobs or increase in medical expenses impairing the socioeconomic status of the sick. Nowadays scientists face this problem and are trying to invent specific pharmacotherapy that allows it to extend life and improve its quality. One of the elements of modern pharmacotherapy is the combination of sacubitril with valsartan. This work aims to evaluate the effect of this drug on the length and quality of life of patients with heart failure.
Materials and methods: This article is a literature review based on publications from PubMed, Cochrane Library, ClinicalKey released since 2014, keywords included: sacubitril/valsartan; angiotensin receptor–neprilysin inhibitor; ARNI; heart failure.
The state of knowledge: The use of sacubitril/valsartan drugs is an established agent used to reduce the risk of death from any cause in all patients with heart failure with reduced ejection fraction, death from cardiovascular causes and the rate of hospitalization due to exacerbation of symptoms. Some study analyses also indicate the utility of using sacubitril/valsartan in HFmrEF and HFpEF to reduce the rate of cardiovascular events and hospitalization because of heart failure.
Conclusions: The use of sacubitril/valsartan is recognized to improve prognosis in patients with HFrEF. Evidence supporting its efficacy in the subgroup of patients with mid-range and preserved ejection fraction is still insufficient and requires further investigation.
References
Bozkurt B et al. Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure. J Card Fail. 2021; 27(3): 441-453. https://doi.org/10.1016/j.cardfail.2021.01.022
Ponikowski P et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016; 37(27): 2129-2200. https://doi.org/10.1093/eurheartj/ehw128
Savarese G et al. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2023; 118(17): 3272-3287. https://doi.org/10.1093/cvr/cvac013
Tsao CW et al. Temporal Trends in the Incidence of and Mortality Associated With Heart Failure With Preserved and Reduced Ejection Fraction. JACC Heart Fail. 2018; 6(8): 678-685. https://doi.org/10.1016/j.jchf.2018.03.006
Dunlay SM, Roger VL, Redfield MM. Epidemiology of heart failure with preserved ejection fraction. Nat Rev Cardiol. 2017; 14(10): 591-602. https://doi.org/10.1038/nrcardio.2017.65
Gerber Y et al. A contemporary appraisal of the heart failure epidemic in Olmsted County, Minnesota, 2000 to 2010. JAMA Intern Med. 2015; 175(6): 996-1004. https://doi.org/10.1001/jamainternmed.2015.0924
Jones NR et al. Survival of patients with chronic heart failure in the community: a systematic review and meta-analysis. Eur J Heart Fail. 2019; 21(11): 1306-1325. https://doi.org/10.1002/ejhf.1594
Regitz-Zagrosek V. Sex and Gender Differences in Heart Failure. Int J Heart Fail. 2020; 2(3): 157-181. https://doi.org/10.36628/ijhf.2020.0004
Hartupee J, Mann DL. Neurohormonal activation in heart failure with reduced ejection fraction. Nat Rev Cardiol. 2017; 14(1): 30-38. https://doi.org/10.1038/nrcardio.2016.163
Borovac JA et al. Sympathetic nervous system activation and heart failure: Current state of evidence and the pathophysiology in the light of novel biomarkers. World J Cardiol. 2020; 12(8): 373-408. https://doi.org/10.4330/wjc.v12.i8.373
Ames MK, Atkins CE, Pitt B. The renin-angiotensin-aldosterone system and its suppression. J Vet Intern Med. 2019; 33(2): 363-382. https://doi.org/10.1111/jvim.15454
Nakamura M, Sadoshima J. Mechanisms of physiological and pathological cardiac hypertrophy. Nat Rev Cardiol. 2018; 15(7): 387-407. https://doi.org/10.1038/s41569-018-0007-y
Bozkurt B et al. Neprilysin Inhibitors in Heart Failure: The Science, Mechanism of Action, Clinical Studies, and Unanswered Questions. JACC Basic Transl Sci. 2022; 8(1): 88-105. https://doi.org/10.1016/j.jacbts.2022.05.010
Nicolas D, Kerndt CC, Reed M. Sacubitril-Valsartan. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 26, 2022.
McMurray JJ et al.; PARADIGM-HF Investigators and Committees. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014; 371(11): 993-1004. https://doi.org/10.1056/NEJMoa1409077
Desai AS et al. Effect of the angiotensin-receptor-neprilysin inhibitor LCZ696 compared with enalapril on mode of death in heart failure patients. Eur Heart J. 2015; 36(30): 1990-1997. https://doi.org/10.1093/eurheartj/ehv186
Hernandez AV, Pasupuleti V, Banach M, Bielecka‐Dabrowa AM. LCZ696 (sacubitril/valsartan) for patients with heart failure. Cochrane Database of Systematic Reviews. 2020; Issue 1. Art. No.: CD013517. https://doi.org/10.1002/14651858.CD013517. Accessed 16 March 2024.
Jhund PS et al. Independence of the blood pressure lowering effect and efficacy of the angiotensin receptor neprilysin inhibitor, LCZ696, in patients with heart failure with preserved ejection fraction: an analysis of the PARAMOUNT trial. Eur J Heart Fail. 2014; 16(6): 671-677. https://doi.org/10.1002/ejhf.76
Solomon SD et al.; PARAGON-HF Investigators and Committees. Angiotensin-Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction. N Engl J Med. 2019; 381(17): 1609-1620. https://doi.org/10.1056/NEJMoa1908655
Mentz RJ et al.; PARAGLIDE-HF Investigators. Angiotensin-Neprilysin Inhibition in Patients With Mildly Reduced or Preserved Ejection Fraction and Worsening Heart Failure. J Am Coll Cardiol. 2023; 82(1): 1-12. https://doi.org/10.1016/j.jacc.2023.04.019
Vaduganathan M et al. Sacubitril/valsartan in heart failure with mildly reduced or preserved ejection fraction: a pre-specified participant-level pooled analysis of PARAGLIDE-HF and PARAGON-HF. Eur Heart J. 2023; 44(31): 2982-2993. https://doi.org/10.1093/eurheartj/ehad344
Chandra A et al. Effects of Sacubitril/Valsartan on Physical and Social Activity Limitations in Patients With Heart Failure: A Secondary Analysis of the PARADIGM-HF Trial. JAMA Cardiol. 2018; 3(6): 498-505. https://doi.org/10.1001/jamacardio.2018.0398
Lewis EF et al. Health-Related Quality of Life Outcomes in PARADIGM-HF. Circ Heart Fail. 2017; 10(8): e003430. https://doi.org/10.1161/CIRCHEARTFAILURE.116.003430
Yan Y et al. SGLT2i versus ARNI in heart failure with reduced ejection fraction: a systematic review and meta-analysis. ESC Heart Fail. 2021; 8(3): 2210-2219. https://doi.org/10.1002/ehf2.13313
Vaduganathan M et al. Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomised controlled trials. Lancet. 2020; 396(10244): 121-128. https://doi.org/10.1016/S0140-6736(20)30748-0
Wang Y et al. Effects of the Angiotensin-Receptor Neprilysin Inhibitor on Cardiac Reverse Remodeling: Meta-Analysis. J Am Heart Assoc. 2019; 8(13): e012272. https://doi.org/10.1161/JAHA.119.012272
Bao J et al. Combination pharmacotherapies for cardiac reverse remodeling in heart failure patients with reduced ejection fraction: A systematic review and network meta-analysis of randomized clinical trials. Pharmacol Res. 2021; 169: 105573. https://doi.org/10.1016/j.phrs.2021.105573
Gu W et al. Echocardiographic changes in elderly patients with heart failure with reduced ejection fraction after sacubitril-valsartan treatment. Cardiovasc Diagn Ther. 2021; 11(5): 1093-1100. https://doi.org/10.21037/cdt-21-355
Liu LW et al. Sacubitril/Valsartan Improves Left Ventricular Ejection Fraction and Reverses Cardiac Remodeling in Taiwanese Patients with Heart Failure and Reduced Ejection Fraction. Acta Cardiol Sin. 2020; 36(2): 125-132. https://doi.org/10.6515/ACS.202003_36(2).20190812A
Yamamoto M et al. Longitudinal Changes in Natriuretic Peptides and Reverse Cardiac Remodeling in Patients with Heart Failure Treated with Sacubitril/Valsartan Across the Left Ventricular Ejection Traction Spectrum. Int Heart J. 2023; 64(6): 1071-1078. https://doi.org/10.1536/ihj.23-407
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Bartosz Sadłowski, Paula Bieganek, Stanisław Łukaszewicz, Piotr Pawłowski, Julia Rybak, Jakub Kordialik, Julia Koćwin, Sandra Sarnacka, Michał Tokarski, Angelika Banasiak
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 118
Number of citations: 0
