About Sacubitril/Valsartan: A Clinically-Oriented Primer for Internists

The medical therapy of heart failure (HF) has been traditionally based on inhibiting the main pathophysiologic mechanisms: the adrenergic and renin-angiotensin-aldosterone systems. Introducing the therapeutical triad of beta-blockers, angiotensin converting enzyme inhibitors and mineralocorticoid receptor antagonists in the treatment of HF patients almost 40 years ago marked an important step since they were not only addressing the symptoms of HF, but also the prognosis and life- expectancy of these patients. Although many discoveries have been made in the past years, no other therapeutic class was able to increase survival among HF patients, until recently, when th SA e benefits of modulating the natriuretic peptide system were brought to the attention of the scientific community. Increasing the levels of natriuretic peptides with Sacubitril/ Valsartan (SV) led to several benefits for the reduced ejection fraction HF population, including less long and short term complications, increased survival and a reduced symptom burden. As this article is being written, it is estimated that more than 2.8 million patients are being treated with SV (1) . Therefore, SV is an important and validated therapy for HF patients and internists should be aware of its indications, benefits and management in clinical practice.