Hospitalización: el momento más vulnerable

Hospitalization for heart failure is part of the natural history of the disease and indicates a deterioration. Even the first hospitalization is associated with an increased risk of death and of repeat hospitalization after discharge. During this period of vulnerability, it is essential that transitional care is carefully managed both before and after discharge: organizational measures should be coordinated and treatment that can modify the disease course should be boosted. The PIONEER and TRANSITION studies demonstrated that sacubitril–valsartan can be started during hospitalization, that it is well tolerated and safe, and that its early administration improves prognostic markers and reduces the risk of rehospitalization compared with enalapril. These benefits extend to patients with de novo heart failure and to those who have not previously received angiotensin-converting enzyme inhibitors. Consequently, there are new opportunities for providing these patients with the treatment needed to reduce the risks associated with hospitalization and to slow disease progression.

Supplement information: this article is part of a supplement entitled “Questions on a new era for heart failure treatment” which is sponsored by Novartis