Neprilysin Inhibitors, HFrEF and 2016 heart failure. Guidelines

Recently i.e. year 2016 both American and European guidelines have recommended combination of Neprilysin inhibitor with ARB i.e. LCZ696 (Sacubitril/valsartan) for treatment of heart failure with reduced ejection fraction(HFrEF)1,2. Landmark trial PARADIGM-HF was prematurely terminated due to significant
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Azilsartan newer ARB, is it pleiotropic?

 Nowadays in pharma industry pleiotropic effect has become a trend. New molecules come with feather stating they have special extra advantage over previous class counterparts. Newer Angiotensin receptor blockers are being added to their group day by day. In
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Should cardiologist stay away from DPP-4 inhibitors in patients with heart failure?

Few days’ back I read article about cardiac benefits of incretin based therapy. How these new classes of drugs reduce the infarct size following MI , PCI and etc. however in that article too GLP 1 agonist did better job … Read the rest

Is it safe to combine Aliskiren with ACE and ARBs?

Aliskiren is a direct renin inhibitor, combining this with ACE and ARBs, block s RAS completely.  Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE) study investigated the effects of Aliskiren in addition to ACE inhibitor or ARB

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Chloroquine for treatment of pulmonary arterial hypertension

Autophagy is cellular survival mechanism during starvation, by Autophagy cells get their energy from lysosomal degradation of its own cellular components. This mechanism is seen more commonly seen in cancer cells. In pulmonary arterial hypertension (PAH), Pulmonary Artery Smooth Muscle

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Levosimendan in acute decompensated heart failure: REVIVE I and II trials


Levosimendan, a myofilament Ca2+ sensitizer, increases myocardial contractility without increase in oxygen demand. Apart from inotropic effects Levosimendan also has vasodilator effects, by stimulation of adenosine triphosphate–dependent potassium channels.

REVIVE I and II are sequential trials, hypothesis was tested in Read the rest

Antisense oligonucleotides technology for reducing triglyceride

Gene expression occurs through formation of messenger RNA (mRNA) synthesized from gene DNA. Oligonucleotidesare small fragments of nucleic acid which can be used as therapeutic agents. In Antisense technology complimentary oligonucleotides are created to mRNA of interest, so this
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Is dabigatran associated with really decreased bleeding risk?

RE-LY trial showed dabigatran 110mg bid was associated with decreased bleeding risk and similar efficacy as warfarin in preventing theombo-embolic events in non valvular AF and at dose 150 mg bid of dabigatran was associated with similar bleeding risk (for

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