Evidencias del sacubitrilo-valsartán en pacientes con diagnóstico reciente de insuficiencia cardiaca

New data confirm the usefulness of sacubitril–valsartan in patients with de novo heart failure (HF) with a reduced left ventricular ejection fraction. Most of these patients do not receive regular treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin-II receptor blockers (ARBs). Although fewer data are available on the usefulness of sacubitril–valsartan in patients with de novo HF than in those with chronic HF, more is known about its use in patients with de novo HF than about the use of other HF drugs, such as ACE inhibitors and ARBs, in these patients. In fact, recent reports support giving sacubitril–valsartan to patients with de novo HF, particularly to those admitted to hospital. Sacubitril–valsartan has similar benefits to enalapril in both patients with de novo HF and those with a history of HF. Consequently, the initial hospital admission for HF with a reduced ejection fraction is a good time to start sacubitril–valsartan. Although information on the use of neprilysin inhibitors in ambulatory patients with de novo HF is scarcer, the data suggest these drugs could also be started in this setting.