Is It Time for a New Standard Therapy for Heart Failure with Reduced Ejection Fraction?
Introduction
Heart failure (HF) with reduced ejection fraction (HFrEF) leads to mortality and impairment in one’s quality of life, and causes a major impact on the healthcare system. Despite trials showing the benefits of angiotensin receptor–neprilysin inhibitor (ARNI) over angiotensin-converting enzyme inhibitors (ACEi), and the superiority of sodium-glucose cotransporter-2 inhibitors (SGLT2i) over placebos, current guidelines still recommend ACEi, mineralocorticoid receptor antagonists (MRA), and beta-blockers as first-line therapy in HFrEF.– In this letter, we will discuss the potential benefits and risks of adopting ARNI and SGLT2i as first-line therapies in HFrEF.
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