STATE OF THE ART PAPER
The evolution of natriuretic peptide augmentation in management of heart failure and the role of sacubitril/valsartan
 
More details
Hide details
Submission date: 2016-03-30
Final revision date: 2016-05-10
Acceptance date: 2016-05-11
Online publication date: 2017-07-03
Publication date: 2017-08-18
 
Arch Med Sci 2017;13(5):1207–1216
 
KEYWORDS
TOPICS
ABSTRACT
Heart failure (HF) is one of the leading causes of morbidity, mortality, and health care expenditures in the US and worldwide. For three decades, the pillars of treatment of HF with reduced ejection fraction (HFrEF) were medications that targeted the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS). Prior attempts to augment the natriuretic peptide system (NPS) for the management of HF failed either due to lack of significant clinical benefit or due to the unacceptable side effect profile. This review article will discuss the NPS, the failure of early drugs which targeted the NPS as therapies for HF, and the sequence of events which led to the development of sacubitril plus valsartan (Entresto; LCZ696; Novartis). LCZ696 has been shown to be superior to the standard of care available for treatment of HFrEF in several substantial hard endpoints including heart failure hospitalizations, cardiovascular mortality, and all-cause mortality.
eISSN:1896-9151
ISSN:1734-1922