ACEi: angiotensin-converting enzyme inhibitor; CI: confidence interval; CV: cardiovascular; HF: heart failure; HFrEF: heart failure with reduced ejection fraction; HR: hazard ratio; LVEF: left ventricular ejection fraction; OR: odds ratio; KCCQ:Kansas City Cardiomyopathy Questionnaire
* Stronger Heart: In PROVE-HF, LVEF increased vs baseline from 28.2% to 37.8% in patients with HFrEF treated with ENTRESTO® at 12 months (difference, 9.4% [95% CI, 8.8% to 9.9%]; P < .001).1 Stronger Life: In PARADIGM-HF, as compared with an Enalapril, ENTRESTO® reduced the risk of hospitalization for heart failure by 21% (HR, 0.79; 95% CI, 0.71 to 0.89; P<0.001) and change in KCCQ clinical summary score at 8 months (between-group difference, 1.64 points; 95% CI, 0.63 to 2.65; P=0.001).2
† ENTRESTO® must not be administered until 36 hours after discontinuing ACEi therapy.3
‡ HR for HF hospitalization 0.79; 95% CI, 0.71 to 0.89; P<0.0012
§ HR for CV death 0.80; 95% CI, 0.71 to 0.89; P<0.0012
# ENTRESTO® was significantly associated with a 5-point or greater improvement in change score difference in combined physical and social activity mean score with adjustment for baseline score at 8-month follow-up (OR, 1.12; 95% CI, 1.00-1.24; P = .04).4
Meet our patients: 4- Symptomatic Heart Failure With Mild Reduced Ejection Fraction Patient
A.M, 68 Years
Newly diagnosed as a HFmrEF patient
68-year-old woman presents at the outpatient clinic complaining of heart failure symptoms
Paroxysmal nocturnal dyspnoea and ankle swelling5 NYHA II-III3
not a real patient
HFmrEF= heart failure with mildly reduced ejection fraction; CKD= chronic kidney disease; LVEF= left ventricular ejection fraction; NYHA= New York Heart Association.
References
Januzzi JL, Prescott MF, Butler J, Felker GM, Maisel AS, McCague K, Camacho A, Piña IL, Rocha RA, Shah AM, Williamson KM. Association of change in N-terminal pro–B-type natriuretic peptide following initiation of sacubitril-valsartan treatment with cardiac structure and function in patients with heart failure with reduced ejection fraction. Jama. 2019 Sep 17;322(11):1085-95.
McMurray JJ, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, Rouleau JL, Shi VC, Solomon SD, Swedberg K, Zile MR. Angiotensin–neprilysin inhibition versus enalapril in heart failure. New England Journal of Medicine. 2014 Sep 11;371(11):993-1004.
Egyptian Drug Authority (EDA). Entresto Approved Leaflet. Approval Date: 07/06/2021.
Chandra A, Lewis EF, Claggett BL, Desai AS, Packer M, Zile MR, Swedberg K, Rouleau JL, Shi VC, Lefkowitz MP, Katova T. Effects of sacubitril/valsartan on physical and social activity limitations in patients with heart failure: a secondary analysis of the PARADIGM-HF trial. JAMA cardiology. 2018 Jun 1;3(6):498-505.
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JG. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. European heart journal. 2021 Sep 21;42(36):3599-726.
Entresto® API
Entresto® API
Approved by Egyptian Drug Authority: HF0068OA4787/102025. Invalidation date: 04/05/2027.
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