Valsartan/sacubitril (Entresto)

A combination of the neprilysin inhibitor sacubitril and angiotensin receptor antagonist valsartan.

Approved for the treatment of patients with group New York heart Association class II-IV heart failure symptoms and reduced ejection fraction.

Use associated with a 20% decrease in death from cardiovascular disease or first hospitalization for heart failure, when compared with the angiotensin-converting inhibitor enlapril. And a 16% reduction in all cause mortality.

Neprilysin, a plasma membrane metalloendopeptidase, and is the principal enzyme for degradation of natriuretic peptides.

This enzyme also degrades multiple peptides including angiotensin, opioids, amyloid beta peptide and bradykinin.

Neprilysin inhibitors increase circulation levels of natriuretic peptides and prevent progression of left ventricular

Demonstrated substantial clinical benefit of Sacubitril-valsartan compared with current standard of care for HF, owing to reductions in cardiovascular mortality and heart failure related related hospitalization ( PARADIGM -HF trial).

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