Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), has been shown to reduce the risk of cardiovascular death or heart failure hospitalization and improve symptoms among patients with chronic heart failure with reduced ejection fraction compared to enalapril, the gold standard angiotensin-converting enzyme inhibitor. In the 5 years since the publication of the results of PARADIGM-HF, further insight has been gained into integrating a neprilysin inhibitor into a comprehensive multidrug regimen, including a renin-angiotensin aldosterone system (RAS) blocker. This paper reviews the current understanding of the effects of sacubitril/valsartan and highlights expected developments over the next 5 years, including potential new indications for use. Additionally, a practical, evidence-based approach is provided to the clinical integration of sacubitril/valsartan among patients with heart failure with reduced ejection fraction.

沙库巴曲/缬沙坦是一种血管紧张素受体脑啡肽酶抑制剂（ARNI），与血管紧张素金标准依那普利相比，已被证明可以降低心血管死亡或心力衰竭住院的风险，并改善射血分数降低的慢性心力衰竭患者的症状。转化酶抑制剂。自 PARADIGM-HF 结果发表以来的 5 年里，人们对将脑啡肽酶抑制剂整合到综合多药治疗方案（包括肾素-血管紧张素醛固酮系统 (RAS) 阻滞剂）中获得了进一步的了解。本文回顾了目前对沙库巴曲/缬沙坦作用的认识，并重点介绍了未来 5 年的预期发展，包括潜在的新使用适应症。此外，还为射血分数降低的心力衰竭患者进行沙库巴曲/缬沙坦的临床整合提供了一种实用的、基于证据的方法。