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Neprilysin Pathway

Jhund and McMurray provide an excellent review of the neprilysin pathway and the role of valsartan/sacubitril in management of patients with heart failure with reduced ejection fraction. There are useful graphics (excerpts follow), a discussion of the high quality of evidence the PARADIGM-HF trial and various considerations including laboratory monitoring (e.g. BNP elevated and not a reliable guide) and use in special subgroups.

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