Description:
Neprilysin (NEP) is an enzyme present in several body cells and is involved in the degradation of natriuretic peptides (NPs), bradykinin (BK), and adrenomedullin (ADM). Furthermore, sacubitril/ valsartan (LCZ696), the frst agent of Angiotensin Receptor Neprilysin Inhibitor (ARNI), has been developed to inhibit both Renin Angiotensin Aldosterone System (RAAS) and NEP. This study, therefore, aimed to discuss the role of sacubitril/valsartan in inhibiting the progression of heart failure (HF) by infuencing the RAAS and NEP pathways. Data on previous articles related to basic theory and clinical trials of ARNI were collected through multiple search engines using the inclusion criteria: articles published in the English language within 2010 to 2020, while additional information on HF guidelines, RAAS, NPs, and ADM were acquired separately. Subsequently, a total of 30 studies were selected and further discussed. According to the results, NEP inhibition leads to a rise in the level of vasodilator agents and is benefcial for HF patients previously prescribed solely RAAS inhibiting agent (Angiotensin Converting Enzyme, ACE-inhibitor and Angiotensin II Receptor Blockers, ARB). In addition, the RAAS, as well as the NEP pathways play a signifcant role in HF progression and are inhibited by sacubitril/valsartan. Also, clinical trials showed sacubitril/valsartan is superior to ACEinhibitor and ARB in clinical trials in treating, as well as reducing the morbidity and mortality rates of patients suffering from HF with reduced ejection fraction (HFrEF).

URL:
http://103.158.96.210:88/web_repository/uploads/28293-124128-1-PB.pdf

Type:
Journal

Document:
Diploma III Farmasi

Date:
23-06-2024

Author:
Sidhi L. Purwowiyoto