ARNI + SGLTi + AMR

This is a combination drug regimen consisting of three classes of medications commonly used in the management of heart failure: - **Angiotensin receptor-neprilysin inhibitor (ARNI):** A dual-acting drug that combines an angiotensin II receptor blocker (ARB) with a neprilysin inhibitor. The most widely used ARNI is sacubitril/valsartan. ARNIs reduce blood pressure and improve cardiac function by blocking the effects of angiotensin II and increasing levels of natriuretic peptides[4][5][6]. - **Sodium-glucose cotransporter 2 inhibitor (SGLTi or SGLT2i):** These are small molecule drugs such as dapagliflozin or empagliflozin that inhibit renal glucose reabsorption, leading to glucosuria and natriuresis. They have demonstrated cardiovascular benefits beyond glycemic control, including reduction in heart failure hospitalizations and mortality[5][6][7]. - **Aldosterone/mineralocorticoid receptor antagonist (AMR/MRA):** Drugs like spironolactone or eplerenone block aldosterone’s action at mineralocorticoid receptors, reducing sodium retention and myocardial fibrosis. The triple combination is being studied for its potential to provide additive or synergistic benefits in patients with advanced heart failure—especially those with preserved ejection fraction (HFpEF)—by targeting multiple pathophysiological pathways including neurohormonal activation, inflammation, fibrosis, fluid overload, and metabolic dysfunction[1]. This regimen has shown promise in improving clinical outcomes such as reducing hospitalization rates for heart failure exacerbations and cardiovascular mortality[1][2].

Other names

ARNI + SGLT2i + MRAARNI + SGLTi + MRAtriple combination therapy (ARNI, SGLT2i, MRA)