Pioneering a New Approach to Acute Decompensated Heart Failure?

Promising results for angiotensin-receptor neprilysin inhibition — but some treatment aspects might not appeal to patients or physicians.

The PARADIGM-HF trial established that angiotensin-receptor neprilysin inhibition (ARNI; sacubitril/valsartan) was superior to the angiotensin-converting enzyme (ACE) inhibitor enalapril for patients with heart failure and reduced ejection fraction (HFrEF). Now, in the manufacturer-sponsored PIONEER-HF trial, researchers assessed the impact of ARNI use in hospitalized individuals with acute decompensated HFrEF (NCT02554890).

The 881 enrollees had reduced ejection fractions, elevated natriuretic peptide levels, and clinically corroborated primary diagnosis of acute decompensated HF (mean age, 61; median left ventricular ejection fraction, 25%; 72% men; 36% black). After hemodynamic stabilization, participants were randomized to twice-daily AR…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)