title: Time to retrieve the best benefits from renin angiotensin aldosterone system (RAAS) inhibition in heart failure patients with reduced ejection fraction: lessons from randomized controlled trials and registries.
abstract: Numerous registries, including the most recent ESC Euro-observational registry, have reported a large and persistent gap between real-life practice in the use of life-saving evidence-based therapies (such as renin angiotensin antagonists, beta-blockers, mineralocorticoid receptor antagonists) and recommended practices in international guidelines. Although the use of multiple renin angiotensin aldosterone system-inhibitors is associated with the development of worsening renal function and hyperkalemia in patients with heart failure and reduced ejection fraction, increased efforts should be expended to initiate and maintain target doses of these agents so as to provide their benefits on mortality and hospitalizations for heart failure.
authors.affiliation: Inserm, Centre d'Investigations Cliniques-Plurithématique 1433, Inserm U1116, Nancy, France; CHU Nancy, Département de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy, France; Université de Lorraine, France; INI-CRCT (Cardiovascular and Renal Clinical Trialists), French-Clinical Research Infrastructure Network (F-CRIN), France. Electronic address: p.rossignol@chu-nancy.fr.
authors.forename: Patrick
authors.initials: P
authors.lastname: Rossignol
authors.affiliation: Inserm, Centre d'Investigations Cliniques-Plurithématique 1433, Inserm U1116, Nancy, France; CHU Nancy, Département de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy, France; Université de Lorraine, France; INI-CRCT (Cardiovascular and Renal Clinical Trialists), French-Clinical Research Infrastructure Network (F-CRIN), France.
authors.forename: Faiez
authors.initials: F
authors.lastname: Zannad
authors.affiliation: University of Michigan School of Medicine, Ann Arbor, MI, USA.
authors.forename: Bertram
authors.initials: B
authors.lastname: Pitt
mesh_terms: D000613:Aminobutyrates / Q000494:pharmacology / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D004338:Drug Combinations; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012042:Registries; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology*; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology*; D013777:Tetrazoles / Q000494:pharmacology / Q000627:therapeutic use; D013997:Time Factors; D000068756:Valsartan
chemical_list: D000613:Aminobutyrates; D057911:Angiotensin Receptor Antagonists; D001713:Biphenyl Compounds; D004338:Drug Combinations; D000451:Mineralocorticoid Receptor Antagonists; D013777:Tetrazoles; D000068756:Valsartan; C549068:sacubitril and valsartan sodium hydrate drug combination
keywords: Heart failure; Kidney function; Potassium; Renin angiotensin aldosterone system inhibition