Department of Cardiology, Apollo Speciality Hospitals Vanagaram, Chennai, India.
Department of Cardiology, Indraprastha Apollo Hospitals, New Delhi, India.
Indian Heart J. 2024 Jul-Aug;76(4):229-239. doi: 10.1016/j.ihj.2024.07.005. Epub 2024 Jul 14.
Novel therapies for heart failure with reduced ejection fraction (HFrEF) are angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose co-transporter 2 inhibitor (SGLT2i), etc. The purpose of this review is to determine the effects of ARNI and SGLT2i in heart failure (HF), compare the impact of SGLT2i with ARNI, and finally evaluate the current data regarding the combination of these two drugs in HF. Various trials on the respective medications have shown some significant reduction in all-cause mortality and cardiovascular (CV) death. The combination of these drugs has shown more CV benefits than monotherapy. There is emerging data about these two drugs in patients with heart failure with preserved ejection fraction (HFpEF). At present, there are less head-to-head comparison trials of these two drugs. This review provides insights on the current evidence, comparative efficacy, and combination therapy of ARNI and SGLT2i in managing HF, focussing on HFrEF and HFpEF.
新型心力衰竭（HFrEF）治疗药物包括血管紧张素受体-脑啡肽酶抑制剂（ARNI）、钠-葡萄糖共转运蛋白 2 抑制剂（SGLT2i）等。本文旨在探讨 ARNI 和 SGLT2i 在心力衰竭（HF）中的作用，比较 SGLT2i 与 ARNI 的影响，最后评估这两种药物联合应用于 HF 的现有数据。各种相关药物试验均表明，全因死亡率和心血管（CV）死亡率均显著降低。与单药治疗相比，联合用药具有更多的 CV 获益。这两种药物在射血分数保留的心力衰竭（HFpEF）患者中的应用也有新数据。目前，这两种药物的头对头比较试验较少。本文就 ARNI 和 SGLT2i 在 HFrEF 和 HFpEF 心力衰竭管理中的现有证据、疗效比较和联合治疗进行综述。
