.webp&w=384&q=75){kind=logo}
Loading, please wait...
Loading, please wait...
PARADIGM-HF established sacubitril/valsartan as a major evidence-based option for patients with heart failure with reduced ejection fraction (HFrEF). In this randomized double-blind trial, sacubitril/valsartan was compared with enalapril in more than 8,000 patients with symptomatic HFrEF. The trial was stopped early because the primary composite endpoint of cardiovascular death or hospitalization for heart failure was significantly lower with sacubitril/valsartan. All-cause mortality was also reduced. For internists, the practical lesson is that neurohormonal modulation in HFrEF should be viewed as a coordinated disease-modifying strategy rather than simply symptom treatment. The study helped shift routine practice toward angiotensin receptor–neprilysin inhibition in eligible patients. Clinicians still need to assess blood pressure, renal function, potassium, prior ACE-inhibitor exposure and the risk of angioedema when selecting therapy. The broader implication for APICON-style guideline-versus-reality discussions is that proven therapies may underperform in practice when initiation is delayed or doses are not optimized. Early, structured implementation of guideline-directed therapy therefore remains a central opportunity for improving outcomes.
Read summarized clinical updates, watch expert medical content, and earn CME certifications right from your smartphone.
Open your smartphone camera to scan and install.
PARADIGM-HF established sacubitril/valsartan as a major evidence-based option for patients with heart failure with reduced ejection fraction (HFrEF). In this randomized double-blind trial, sacubitril/valsartan was compared with enalapril in more than 8,000 patients with symptomatic HFrEF. The trial was stopped early because the primary composite endpoint of cardiovascular death or hospitalization for heart failure was significantly lower with sacubitril/valsartan. All-cause mortality was also reduced. For internists, the practical lesson is that neurohormonal modulation in HFrEF should be viewed as a coordinated disease-modifying strategy rather than simply symptom treatment. The study helped shift routine practice toward angiotensin receptor–neprilysin inhibition in eligible patients. Clinicians still need to assess blood pressure, renal function, potassium, prior ACE-inhibitor exposure and the risk of angioedema when selecting therapy. The broader implication for APICON-style guideline-versus-reality discussions is that proven therapies may underperform in practice when initiation is delayed or doses are not optimized. Early, structured implementation of guideline-directed therapy therefore remains a central opportunity for improving outcomes.
Today
The phase 3 ACACIA-HCM trial reveals that aficamten improves cardiac structure, diastolic relaxation, functional capacity, and symptom burden in symptomatic nonobstructive hypertrophic cardiomyopathy, marking a major milestone in targeted myosin inhibition.
6 days back
A clinical study shows that automated breast ultrasound paired with artificial intelligence accurately classifies BIRADS 3-4 lesions, reaching 95% sensitivity and 79% specificity. This diagnostic advance promises to reduce unnecessary core needle biopsies and refine clinical workflows in breast imaging.
3 weeks back
Researchers have engineered freestanding hierarchical-porous BCZT thin films that resist cracking and enhance ultrasonic energy harvesting in soft tissue. Achieving high piezoelectric output and acoustic matching, this lead-free material offers transformative potential for implantable bioelectronics.
6 days back
A novel pathology-adaptive surface engineering strategy uses functionalized plasma polymer coatings to selectively modulate AGE adsorption, reducing oxidative stress and restoring bone formation in diabetic and aging microenvironments.
3 weeks back
A breakthrough study identifies the Klotho/PKCα/CUX1/SPARC/TGFβ-RII axis as a critical driver of podocyte mitochondrial injury and ferroptosis in diabetic kidney disease, unveiling promising molecular targets to halt renal disease progression.
6 days back
