Chegou a Hora de uma Nova Terapia Padrão para a Insuficiência Cardíaca com Fração de Ejeção Reduzida

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.1 - 3In this letter, we will discuss the potential benefits and risks of adopting ARNI and SGLT2i as first-line therapies in HFrEF.