Data Support National Guidelines for ARNI Therapy in Eligible Patients with Heart Failure with Reduced Ejection Fraction

MedicalResearch.com Interview with:
Pratyaksh K. Srivastava, MD
Division of General Internal Medicine, UCLA
Gregg C. Fonarow, MD
Ahmanson-UCLA Cardiomyopathy Center
UCLA  Medical Center, Los Angeles
Associate Editor, JAMA Cardiology

MedicalResearch.com: What is the background for this study? 

Response: Angiotensin Receptor-Neprilysin Inhibitors represent a novel class of heart failure therapeutics that have been shown to significantly improve mortality among patients with heart failure with reduced ejection fraction (HFrEF).

In the Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor (ARNI) with Angiotensin Converting Enzyme Inhibitor (ACEI) to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial, sacubitril-valsartan was associated with a 20% relative risk reduction in the primary outcome of death from cardiovascular causes or first hospitalization for worsening heart failure over a median follow up of 27 months.

In our current study, we present long term (5-year) absolute risk reductions associated with the addition of angiotensin receptor-neprilysin inhibition to standard HFrEF background therapy using data from PARADIGM-HF. We utilize the number needed to treat (NNT) to quantify absolute risk reduction, and ultimately compare 5-year NNT values for sacubitril-valsartan to those of well-established HFrEF therapeutics for the outcome of all-cause mortality.

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