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Christopher T. Salerno, MD, is a highly skilled cardiac surgeon who specializes in complex heart surgery at UChicago Medicine.
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Aug 17, 2020 · We assessed the renal effects of angiotensin/neprilysin inhibition in patients who have heart failure with preserved ejection fraction enrolled in the PARAGON-HF trial (Prospective Comparison of ARNI With ARB Global Outcomes in HF With Preserved Ejection Fraction).
- Finnian R. Mc Causland, Finnian R. Mc Causland, Martin P. Lefkowitz, Brian Claggett, Brian Claggett,...
- 2020
- Conflict of Interest
- Barry Greenberg , MD
- ABSTRACT
- CLINICAL TRIALS WITH COMBINED NEPRILYSIN-ANGIOTENSIN INHIBITION IN PATIENTS WITH HFREF
- Who should be treated with an ARNI?
- Should ARNI's be used as monotherapy or in association with other agents? If not, is there a specific order in which neurohormonal modulating drugs should be initiated?
- CONCLUSIONS AND FUTURE DIRECTIONS
The author has no financial conflicts of interest.
Sulpizio Family Cardiovascular Center and University of California, San Diego Medical Center, La Jolla, CA, USA
Recognition that neurohormonal activation plays a central role in the pathogenesis of heart failure (HF) led to the development of angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers, mineralocorticoid receptor antagonists and beta blockers. While there has been substantial success with these neurohormonal blocking drugs...
In addition to contributing to the breakdown of counter-regulatory peptides, neprilysin also is involved in the metabolism of Ang II. Since the use of a neprilysin inhibitor alone would increase levels of Ang II, a peptide known to mediate long-term adverse efects on the heart and blood vessels, as well as the levels of potentially beneficial pepti...
The clinical trial results reviewed in this manuscript provide compelling evidence that sacubitril-valsartan should be considered as first line therapy in patients with class C HFrEF. An ARNI can be started either in-hospital once the patient has stabilized (according to criteria outlined in the PIONEER-HF study) or in the out-patient setting. Ther...
In patients with class C HFrEF ARNI's should be used in association with an evidence based beta blocker (i.e., carvedilol, either short or long-acting, metoprolol succinate or bisoprolol) and an MRA. The order in which these agents should be used is left to the discretion of the clinician managing the patient's care. The practice of the author is t...
The development and testing of an ARNI in randomized clinical trials (RCTs) has resulted in an important new approach for managing patients with stage C HFrEF. Available evidence shows that sacubitril-valsartan is superior to enalapril in improving outcomes in this population. As a result, the use of sacubitril-valsartan is now guideline recommende...
- Barry Greenberg
- 2020
Apr 17, 2023 · ARNI has demonstrated superior cardioprotective effects compared with renin–angiotensin system inhibitors (RAS‐Is) in large clinical trials such as the PARADIGM‐HF (Prospective Comparison of ARNI With ACEI [Angiotensin‐Converting Enzyme Inhibitor] to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial.
Mar 8, 2024 · Contemporary use of sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) and angiotensin receptor‐neprilysin inhibitors (ARNi) in patients with atrial fibrillation (AF) and heart failure (HF) has not been described.
Apr 28, 2019 · Indeed, a new class of drug, the angiotensin receptor–neprilysin inhibitors (ARNi), has the ability to counteract the effects of angiotensin II as well as to increase the activity of NPs. ARNi have already been proven to be effective in the treatment of heart failure with reduced ejection fraction.
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Is Arni a renin-angiotensin system inhibitor?
What does Arni mean?
Can Arni be used to treat heart failure with reduced ejection fraction?
What does Ace and Arni mean?
What is the difference between Arni and sglt2i?
How does Arni affect the kidneys?
Sep 8, 2023 · Validated algorithms were used to identify patients with AF and HF, and to classify patients into HF with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF). We assessed the prevalence of SGLT2i and ARNi use overall and by HF type.
