Put New Heart Failure Guidelines in Perspective

Big changes in guidelines will lead to debate about managing heart failure with reduced ejection fraction (HFrEF).

We're used to "triple therapy" for HFrEF...an ACEI or ARB, an evidence-based beta-blocker (carvedilol, etc), and an aldosterone antagonist (spironolactone, etc)...to reduce hospitalizations and death.

Now Entresto (sacubitril/valsartan) is preferred INSTEAD of an ACEI or ARB when possible...since it prevents hospitalization or CV death in about 1 in 21 patients versus an ACEI.