3-10ANGIOTENSIN RECEPTOR NEPRILYSIN INHIBITORS (ARNI) POTENTIALS IN PATIENT WITH HEART FAILURE: A SYSTEMATIC REVIEW

Abstract

Background: Structural and/or functional cardiac abnormalities that lead to elevated intracardiac pressures with/without reduced output known as heart failure. Progressive establishment of the disease grows concomitantly with the number of cases despite the availability of various therapies. The recent standard recommends the substitution of angiotensin-converting-enzyme (ACE) inhibitors or angiotensin-II receptor blockers (ARBs) with angiotensin receptor blocker-neprilysin inhibitors (ARNI) in selected patients. The capacity of ARNI will be analyzed based on the latest clinical trials available. Objective: This study focus on revealing the clinical impact and potentials of ARNI in an attempt to counteract the decreasing capacity of the heart. Method: Literature finding involves four scientific databases, including PubMed, EbscoHost, ProQuest, and Cochrane. The primary search was concluded using certain Medical Subject Heading (MeSH) terms and filters. Two independent authors further analyzed selected interventional articles related to ARNI and heart failure. Relevance studies were reviewed using the Centre for Evidence-based Medicine (CEBM) critical appraisal tool to turn aside bias. The result: Data were collected from patients in three randomized controlled trials within five articles. Four of the reports investigate the use of ARNI compared to enalapril in acute decompensated heart failure (ADHF) and chronic heart failure (CHF). Another study compared ARNI to valsartan only therapy in heart failure patients with reduced ejection fraction (HFrEF). It shows that the use of ARNI contributes to a lower number of hospitalization cases and mortality rates while preventing further progression of heart failure. Conclusion: ARNI has adequate potential to prevent the progression of the disease while the encouragement of future investigation is essential.