Drug therapy for patients with systolic heart failure after the PARADIGM-HF trial: in need of a new paradigm of LCZ696 implementation in clinical practice

BMC Medicine

John Lekakis¹  John Parissis¹  Dimitrios Farmakis¹  Gerasimos Filippatos¹ 

[1] Heart Failure Unit, Department of Cardiology, Athens University Hospital “Attikon”, 1 Rimini St, 12462 Haidari, Athens, Greece

关键词: Sacubitril;    Valsartan;    Neprilysin;    Angiotensin-converting enzyme inhibitor;    PARADIGM-HF;    LCZ696;    Therapy;    Heart failure;   

Others  :  1127606
DOI  :  10.1186/s12916-015-0272-0

 received in 2015-01-07, accepted in 2015-01-09,  发布年份 2015

【 摘 要 】

Heart failure represents a primary cause of morbidity and mortality in older people and despite significant therapeutic advances, it is still characterized by important unmet needs, thus remaining a challenging field of clinical research. The recent PARADIGM-HF trial compared the novel compound LCZ696, a combination of the angiotensin receptor blocker valsartan and the neprilysin inhibitor sacubitril, versus the angiotensin-converting enzyme inhibitor enalapril in 8,442 patients with symptomatic chronic systolic heart failure. LCZ696 led to a 20% reduction in the rate of death or hospitalization for heart failure and a 16% reduction in the rate of all-cause death compared to enalapril at 3.5 years of follow-up. Despite those impressive results, the clinical application of this novel agent that requires the substitution of a cornerstone of current heart failure therapy, the angiotensin-converting enzyme inhibitors, should follow careful steps as imposed by the study design, the recruited population and the outcome in specific patient subgroups. Further insights into the effects of LCZ696 will be provided by the ongoing PARAGON-HF trial in patients with diastolic heart failure.

【 授权许可】

   
2015 Filippatos et al.; licensee BioMed Central.

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