Angiotensin–Neprilysin Inhibition in Acute Decompensated Heart Failure

Published on Feb 7, 2019in The New England Journal of Medicine74.699
· DOI :10.1056/NEJMOA1812851
Eric J. Velazquez13
Estimated H-index: 13
(Yale University),
Eric J. Velazquez79
Estimated H-index: 79
(Yale University)
+ 6 AuthorsPioneer-Hf Investigators3
Estimated H-index: 3
Sources
Abstract
Abstract Background Acute decompensated heart failure accounts for more than 1 million hospitalizations in the United States annually. Whether the initiation of sacubitril–valsartan therapy is safe and effective among patients who are hospitalized for acute decompensated heart failure is unknown. Methods We enrolled patients with heart failure with reduced ejection fraction who were hospitalized for acute decompensated heart failure at 129 sites in the United States. After hemodynamic stabilization, patients were randomly assigned to receive sacubitril–valsartan (target dose, 97 mg of sacubitril with 103 mg of valsartan twice daily) or enalapril (target dose, 10 mg twice daily). The primary efficacy outcome was the time-averaged proportional change in the N-terminal pro–B-type natriuretic peptide (NT-proBNP) concentration from baseline through weeks 4 and 8. Key safety outcomes were the rates of worsening renal function, hyperkalemia, symptomatic hypotension, and angioedema. Results Of the 881 patients wh...
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