@article{3100627,
    title = "Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper",
    author = "Ntalianis, A. and Chrysohoou, C. and Giannakoulas, G. and Giamouzis, G. and Karavidas, A. and Naka, A. and Papadopoulos, C.H. and Patsilinakos, S. and Parissis, J. and Tziakas, D. and Kanakakis, J.",
    journal = "Heart Failure Reviews",
    year = "2022",
    volume = "27",
    number = "1",
    publisher = "Springer-Verlag",
    issn = "1382-4147",
    doi = "10.1007/s10741-021-10115-8",
    keywords = "amino terminal pro brain natriuretic peptide;  angiotensin receptor antagonist;  beta adrenergic receptor blocking agent;  dipeptidyl carboxypeptidase inhibitor;  diuretic agent;  membrane metalloendopeptidase;  sacubitril plus valsartan;  aminobutyric acid derivative;  angiotensin derivative;  angiotensin receptor;  biphenyl derivative;  membrane metalloendopeptidase;  sacubitril, acute heart failure;  clinical study;  consensus;  cost effectiveness analysis;  drug administration route;  forward heart failure;  health care utilization;  heart failure with reduced ejection fraction;  heart left ventricle ejection fraction;  hospital;  hospital discharge;  hospitalization;  human;  hyperkalemia;  hypotension;  kidney dysfunction;  patient care;  Review;  time to treatment;  unmet medical need;  heart failure;  heart stroke volume;  multicenter study (topic);  prospective study;  randomized controlled trial (topic);  treatment outcome, Aminobutyrates;  Angiotensin Receptor Antagonists;  Angiotensins;  Biphenyl Compounds;  Consensus;  Heart Failure;  Humans;  Multicenter Studies as Topic;  Neprilysin;  Prospective Studies;  Randomized Controlled Trials as Topic;  Receptors, Angiotensin;  Stroke Volume;  Treatment Outcome",
    abstract = "The short-term mortality and rehospitalization rates after admission for acute heart failure (AHF) remain high, despite the high level of adherence to contemporary practice guidelines. Observational data from non-randomized studies in AHF strongly support the in-hospital administration of oral evidence-based modifying chronic heart failure (HF) medications (i.e., b-blockers, ACE inhibitors, mineralocorticoid receptor antagonists) to reduce morbidity and mortality. Interestingly, a well-designed prospective randomized multicenter study (PIONEER-HF) showed an improved clinical outcome and stress/injury biomarker profile after in-hospital administration of sacubitril/valsartan (sac/val) as compared to enalapril, in hemodynamically stable patients with AHF. However, sac/val implementation during hospitalization remains suboptimal due to the lack of an integrated individualized plan or well-defined appropriateness criteria for transition to oral therapies, an absence of specific guidelines regarding dose selection and the up-titration process, and uncertainty regarding patient eligibility. In the present expert consensus position paper, clinical practical recommendations are proposed, together with an action plan algorithm, to encourage and facilitate sac/val administration during hospitalization after an AHF episode with the aim of improving efficiencies of care and resource utilization. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature."
}