The 2022 AHA/ACC/HFSA Heart Failure Guideline recognizes ENTRESTO® in three heart failure patient populations1†
HFrEF LVEF ≤40%
-
HFrEF LVEF ≤40%
-
HFmrEF LVEF 41%-49%
-
HFpEF LVEF ≥50%
The 2022 AHA/ACC/HFSA Heart Failure Guideline recognizes ENTRESTO® in three heart failure patient populations1†
HFrEF
LVEF ≤40%
HFmrEF
LVEF 41%-49%
HFpEF
LVEF ≥50%
Patients with LVEF below normal who may be appropriate for ENTRESTO2
HFrEF: The Heart Failure Guideline recommends ENTRESTO to reduce morbidity and mortality‡
‡NYHA class II/III patients with HFrEF.
START
YOUR NEWLY DIAGNOSED
PATIENTS WITH THE
PREFERRED RASi
Class 1 recommendation as a
FIRST-LINE TREATMENT and
PREFERRED INSTEAD OF ACEi/ARB1
Class 1 recommendation as a FIRST-LINE TREATMENT and PREFERRED INSTEAD OF ACEi/ARB1
SWITCH
YOUR EXISTING
ACEi/ARB PATIENTS
NOW
Class 1 recommendation to REPLACE ACEi/ARB1§
Class 1 recommendation to REPLACE ACEi/ARB1§
§In patients who tolerate ACEi/ARB.
ENTRESTO is the ONLY BRANDED HEART FAILURE MEDICATION
deemed by the Heart Failure Guideline to provide HIGH ECONOMIC VALUE1‖
In patients with chronic symptomatic HFrEF, treatment with ENTRESTO instead of an ACEi provides HIGH ECONOMIC VALUE
Multiple analyses found ENTRESTO to be HIGH VALUE compared to an ACEi in the outpatient setting
Inpatient initiation of ENTRESTO was seen as HIGH VALUE compared with delayed initiation post-discharge
‖Value statements for select therapies were created based upon benchmarks adopted by AHA/ACC/HFSA where high-quality cost-effectiveness studies of the intervention had been published.

See how the Heart Failure Guideline recognizes ENTRESTO
for select HFmrEF patients, particularly for patients
with LVEF on the lower end of this spectrum1,2
†In the 2022 Heart Failure Guideline, ENTRESTO is recommended as a first-line treatment and to replace well-tolerated ACEi/ARB in patients with HFrEF. ENTRESTO was also included as a treatment option for HFmrEF (LVEF 41%-49%) and selected patients with HFpEF (LVEF ≥50%), particularly for patients with LVEF on the lower end of these spectrums.
*In PARAGON-HF, defined as LVEF ≥45% with structural heart disease (LAE or LVH); median LVEF was 57%. LVEF is a variable measure and the normal range can vary.2
ACC=American College of Cardiology; ACEi=angiotensin-converting enzyme inhibitor; AHA=American Heart Association; ARB=angiotensin II receptor blocker; HFmrEF=heart failure with mildly reduced ejection fraction; HFpEF=heart failure with preserved ejection fraction;
HFrEF=heart failure with reduced ejection fraction; HFSA=Heart Failure Society of America; LAE=left atrial enlargement; LVEF=left ventricular ejection fraction; LVH=left ventricular hypertrophy;
MRA=mineralocorticoid receptor antagonist; NYHA=New York Heart Association; RASi=renin-angiotensin system inhibitor.
Patients with LVEF below normal who may be appropriate for ENTRESTO2
The 2022 Heart Failure Guideline expands its recognition of ENTRESTO to select HFmrEF patients1
HFmrEF
Consider ENTRESTO in HFmrEF to reduce the risk of HEART FAILURE HOSPITALIZATION AND CV MORTALITY, particularly for patients with LVEF on the lower end of this spectrum.1
Consider ENTRESTO in HFmrEF to reduce the risk of HEART FAILURE HOSPITALIZATION AND CV MORTALITY, particularly for patients with LVEF on the lower end of this spectrum.1

See how the Heart Failure Guideline recognizes ENTRESTO for select HFpEF patients, particuarly for patients with LVEF on the lower end of this spectrum1,2
†In the 2022 Heart Failure Guideline, ENTRESTO is recommended as a first-line treatment and to replace well-tolerated ACEi/ARB in patients with HFrEF. ENTRESTO was also included as a treatment option for HFmrEF (LVEF 41%-49%) and selected patients with HFpEF (LVEF ≥50%), particularly for patients with LVEF on the lower end of these spectrums.
*In PARAGON-HF, defined as LVEF ≥45% with structural heart disease (LAE or LVH); median LVEF was 57%. LVEF is a variable measure and the normal range can vary.2
ACC=American College of Cardiology; ACEi=angiotensin-converting enzyme inhibitor; AHA=American Heart Association;
ARB=angiotensin II receptor blocker; CV=cardiovascular; HFmrEF=heart failure with mildly reduced ejection fraction; HFpEF=heart failure with preserved ejection fraction;
HFrEF=heart failure with reduced ejection fraction; HFSA=Heart Failure Society of America; LAE=left atrial enlargement;
LVEF=left ventricular ejection fraction; LVH=left ventricular hypertrophy.
Patients with LVEF below normal who may be appropriate for ENTRESTO2
The 2022 Heart Failure Guideline expands its recognition of ENTRESTO to select HFpEF patients1
SELECT PATIENTS WITH
HFpEF
Consider ENTRESTO in HFpEF to decrease
HEART FAILURE HOSPITALIZATIONS,2‡ particularly for patients with LVEF on the lower end of this spectrum.1
†In the 2022 Heart Failure Guideline, ENTRESTO is recommended as a first-line treatment and to replace well-tolerated ACEi/ARB in patients with HFrEF. ENTRESTO was also included as a treatment option for HFmrEF (LVEF 41%-49%) and selected patients with HFpEF (LVEF ≥50%), particularly for patients with LVEF on the lower end of these spectrums.
‡PARAGON-HF was a randomized, double-blind, active-controlled trial comparing ENTRESTO to valsartan in 4796 adult patients with symptomatic (NYHA Class II–IV) HFpEF ≥45%, elevated levels of natriuretic peptides, and structural heart disease. After completing the run-in period with valsartan followed by ENTRESTO, patients entered the double-blind period and were randomly assigned (1:1) to ENTRESTO 97/103 mg BID (n=2407) or valsartan 160 mg BID (n=2389). The median follow-up duration was 35 months, and patients were treated for up to 4.7 years. At the primary end point, reduction in the composite of total (first and recurrent) HF hospitalizations and CV death, ENTRESTO did not achieve statistical significance vs valsartan (RR 0.87; 95% CI: 0.75, 1.01; P=0.06).2

See the ACC Expert Consensus Decision Pathway
recommendation of ENTRESTO for select HFrEF patients
*In PARAGON-HF, defined as LVEF ≥45% with structural heart disease (LAE or LVH); median LVEF was 57%. LVEF is a variable measure and the normal range can vary.2
ACC=American College of Cardiology; ACEi=angiotensin-converting enzyme inhibitor; AHA=American Heart Association; ARB=angiotensin II receptor blocker; ARR=absolute rate reduction; CI=confidence interval; CVD=cardiovascular death; ECDP=Expert Consensus Decision Pathway; HFH=heart failure hospitalization; HFmrEF=heart failure with mildly reduced ejection fraction; HFpEF=heart failure with preserved ejection fraction; HFrEF=heart failure with reduced ejection fraction; HFSA=Heart Failure Society of America; LAE=left atrial enlargement; LVEF=left ventricular ejection fraction; LVH=left ventricular hypertrophy; RR=relative rate.