Τίτλος:
Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Ntalianis, A.
Chrysohoou, C.
Giannakoulas, G.
Giamouzis, G.
Karavidas, A.
Naka, A.
Papadopoulos, C.H.
Patsilinakos, S.
Parissis, J.
Tziakas, D.
Kanakakis, J.
Περιοδικό:
Heart Failure Reviews
Λέξεις-κλειδιά:
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
DOI:
10.1007/s10741-021-10115-8
