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Revue médicale suisse · Oct 2019
Review[« ARNI » (Angiotensin Receptor-Neprilysin Inhibitor): when, for whom and how?]
- Larissa Russo-Vorms, Philippe Meyer, and Jean-Luc Reny.
- Service de médecine interne générale, Département de médecine et service de médecine de premier recours, Département de médecine communautaire, HUG, 1211 Genève 14.
- Rev Med Suisse. 2019 Oct 16; 15 (667): 1882-1886.
AbstractThe association of an angiotensin II receptor antagonist and a neprilysin inhibitor (ARNI or Angiotensin Receptor-Neprilysin Inhibitor) is a new actor in the management of heart failure with reduced left ventricular ejection fraction (LVEF). The PARADIGM-HF trial performed in outpatients with a LVEF ≤ 35-40 % demonstrated that sacubitril-valsartan was superior to enalapril in reducing cardiovascular mortality and heart failure hospitalizations. Precautions in the initiation of sacubitril-valsartan, its use as well as its place in the drug management strategy for chronic heart failure are described in the present review. Additional data in patients hospitalized with reduced LVEF, in patients with LVEF > 45 % as well as the effects on blood pressure, renal or cognitive functions are presented.
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