The role of angiotensin receptor-neprilysin inhibitors in cardiovascular disease-existing evidence, knowledge gaps, and future directions

European Journal of Heart Failure
Andrew P AmbrosyScott D Solomon

Abstract

Although traditional renin-angiotensin system antagonists including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have revolutionized the treatment of cardiovascular disease (CVD), the pivotal PARADIGM-HF trial demonstrated that sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), was superior to an angiotensin-converting enzyme inhibitor in reducing cardiovascular morbidity and mortality in patients with heart failure and reduced ejection fraction. However, despite international regulatory approval and strong recommendations in the guidelines, uptake of sacubitril/valsartan has been disappointing. Sacubitril/valsartan is now the focus of a large programme of clinical trials testing the hypothesis that ARNIs may supplant conventional renin-angiotensin system inhibitors across the spectrum of CVD, including hypertension, secondary prevention after myocardial infarction, and heart failure with preserved ejection fraction. This review summarizes the existing evidence, knowledge gaps, and future directions of ARNIs in CVD based on discussions between clinical trialists, industry representatives, and regulatory authorities at the 2016 Global CardioVascular Clinical Trialists Forum i...Continue Reading

References

Aug 1, 1991·The New England Journal of Medicine·UNKNOWN SOLVD InvestigatorsJay N Cohn
Nov 12, 2003·The New England Journal of Medicine·Marc A PfefferUNKNOWN Valsartan in Acute Myocardial Infarction Trial Investigators
Dec 5, 2008·The New England Journal of Medicine·Kenneth JamersonUNKNOWN ACCOMPLISH Trial Investigators
Aug 31, 2012·Lancet·Scott D SolomonUNKNOWN Prospective comparison of ARNI with ARB on Management Of heart failUre with preserved ejectioN fracTion (PARAMOUNT) Investig
Nov 6, 2012·International Journal of Cardiology·Robert J MentzBertram Pitt
Apr 11, 2014·The New England Journal of Medicine·Bertram PittUNKNOWN TOPCAT Investigators
Sep 2, 2014·The New England Journal of Medicine·John J V McMurrayUNKNOWN PARADIGM-HF Investigators and Committees
Dec 3, 2015·The New England Journal of Medicine·Brian ClaggettUNKNOWN PARADIGM-HF Investigators
Dec 15, 2015·Journal of the American College of Cardiology·Stuart J PocockTim J Collier
Dec 18, 2015·Circulation·UNKNOWN Writing Group MembersUNKNOWN Stroke Statistics Subcommittee
Apr 25, 2016·JACC. Heart Failure·Milton Packer
Apr 25, 2016·JACC. Heart Failure·Arthur M Feldman
Apr 25, 2016·JACC. Heart Failure·Christopher M O'ConnorJoAnn Lindenfeld
Jul 11, 2016·JACC. Heart Failure·Scott D SolomonJohn J V McMurray
Jul 16, 2016·Journal of the American College of Cardiology·Akshay S DesaiUNKNOWN PARADIGM-HF Investigators
Aug 10, 2016·Circulation·Lynne T BraunUNKNOWN American Heart Association Advocacy Coordinating Committee
Aug 30, 2016·Annals of Internal Medicine·Alexander T SandhuPaul A Heidenreich
Aug 30, 2016·Annals of Internal Medicine·Milton PackerMichael Emmett
Oct 18, 2016·Current Cardiology Reports·Muthiah Vaduganathan, Akshay S Desai
Nov 22, 2016·European Journal of Heart Failure·Jane A CannonUNKNOWN PARADIGM-HF Investigators and Committees
Dec 3, 2016·Journal of the American College of Cardiology·Michael R ZileScott D Solomon
Dec 28, 2016·Journal of the American College of Cardiology·Frederick A MasoudiJohn A Spertus
Mar 1, 2017·European Journal of Heart Failure·Pierpaolo PellicoriAndrew L Clark

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Citations

Jun 23, 2018·European Journal of Heart Failure·Andrew P Ambrosy, Ovidiu Chioncel
Oct 16, 2018·Journal of Cardiovascular Medicine·Renato De Vecchis, Carmelina Ariano
Feb 7, 2019·The New England Journal of Medicine·John Jarcho
Jul 11, 2019·Journal of Comparative Effectiveness Research·Herminio Morillas-ClimentAlfonso Valle-Muñoz
Aug 10, 2019·Journal of Cardiovascular Medicine·Edoardo SciattiCarlo Mario Lombardi
Feb 28, 2020·European Journal of Heart Failure·Marianna AdamoMarco Metra
Jul 31, 2020·European Journal of Heart Failure·Marianna AdamoMarco Metra
Nov 21, 2019·European Journal of Heart Failure·Marianna AdamoMarco Metra
Jun 27, 2019·Current Cardiology Reviews·Juan SalazarValmore Bermúdez
Aug 18, 2020·Therapeutics and Clinical Risk Management·Sara AkbarWilbert S Aronow
Jun 22, 2018·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Antonis S ManolisHelen Melita
Nov 13, 2018·The New England Journal of Medicine·Eric J VelazquezUNKNOWN PIONEER-HF Investigators
Jan 31, 2020·ESC Heart Failure·Daniela TomasoniMarco Metra
Oct 30, 2020·European Journal of Heart Failure·Daniela TomasoniMarco Metra
Dec 6, 2020·ESC Heart Failure·Daniela TomasoniMarco Metra
Aug 29, 2020·Journal of the American College of Cardiology·Andrew P AmbrosyUNKNOWN PIONEER-HF Investigators

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