Is Entresto good for the brain?

The main stay pharmacotherapy for heart failure(HF) is targeted towards rennin-angiotensin-aldosterone(RAAS) and neprilysin pathways(NP). Both therapeutic strategies decreases morbidity and mortality but also carry considerable adverse effects. This review of the literature highlights the new genera...

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Published inWorld journal of cardiology Vol. 9; no. 7; pp. 594 - 599
Main Authors Patel, Nirav, Gluck, Jason
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 26.07.2017
Subjects
Minireviews
Heart failure
Sacubitril-valsartan
LCZ696
Alzheimer’s disease
Entresto
Neprilysin inhibitor
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Summary:The main stay pharmacotherapy for heart failure(HF) is targeted towards rennin-angiotensin-aldosterone(RAAS) and neprilysin pathways(NP). Both therapeutic strategies decreases morbidity and mortality but also carry considerable adverse effects. This review of the literature highlights the new generation of HF drug, sacubitril-valsartan(SV), trade name Entresto(researched as LCZ696, Novartis) which simultaneously blocks RAAS and NP. This dual action of angiotensin receptors blocker and neprilysin inhibitor(NPi) has improved HF prognosis and it is an evolution in the management of HF. Although the initial follow-up of patients treated with SV has yielded promising results, there are concerns regarding potential side effects especially an increase in the risk of Alzheimer’s disease(AD) and young onset of AD. NPi interferes with the breakdown and clearing of beta-amyloid peptides, the plaques seen in AD, raising concern for AD in SV patients. On the other hand, hypertension and cardiovascular diseases are established risk factors for AD which can be decreased by SV therapy. It is therefore essential that SV treated patients are followed up over an extended period of time to detect any adverse cognitive changes.
Bibliography:Nirav Patel;Jason Gluck;Department of Cardiology, University of Connecticut, Harford Hospital
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Telephone: +1-860-9721793 Fax: +1-860-5453422
Author contributions: Patel N made substantial contributions to conception and design and writing the manuscript; Gluck J participated drafting the manuscript and revising it critically for important intellectual content; Gluck J was also involved in editing the content; Patel N and Gluck J gave final approval of the submitted content as well as the revised content.
Correspondence to: Nirav Patel, MD, Department of Cardiology, University of Connecticut, Harford Hospital, 80 Seymour Street, Hartford, CT 06102, United States. nirav.patel@hhchealth.org
ISSN:1949-8462
1949-8462
DOI:10.4330/wjc.v9.i7.594