In this issue of JAMA Cardiology, Packer offers a provocative viewpoint titled “Angiotensin Neprilysin Inhibition for Patients With Heart Failure: What If Sacubitril/Valsartan Were a Treatment for Cancer?” This article challenges the absence of urgency in the treatment of patients with heart failure, noting that the malignancy of heart failure can be similar to cancer. The compelling argument for more rapid uptake is a poignant and appropriate point for discussion by the larger cardiovascular community. This is not an isolated observation, as the uptake of other evidence-based therapies for heart failure, including aldosterone antagonists, cardiac resynchronization therapy devices, implantable cardioverter defibrillators, isosorbide dinitrate/hydralazine, and even evidence-based β-blockers, was not robust. Moreover, few, if any, cardiovascular therapies are fully penetrated in at-risk patient groups.
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