The Food and Drug Administration (FDA) last approved a new oral drug (hydralazine–isosorbide dinitrate) for patients with heart failure and a reduced ejection fraction in 2005 — and this drug was recommended only for self-identified black patients who continued to have symptoms despite evidence-based treatment.1 TThe aldosterone antagonist eplerenone was approved for the treatment of heart failure in 2003. (In 2012, the European Medicines Agency approved ivabradine, which has not received FDA approval.) Now, a novel drug, LCZ696, a dual inhibitor of angiotensin II receptor and neprilysin, may prove to be the first disruptive agent to the heart-failure treatment algorithm











