Aims To assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF) who are eligible for sacubitril/valsartan (LCZ696) based on the European Medicines Agency/Food and Drug Administration (EMA/FDA) label, the PARADIGM‐HF trial and the 2016 ESC guidelines, and the association between eligibility and outcomes. Methods and results Outpatients with HFrEF in the ESC‐EORP‐HFA Long‐Term Heart Failure (HF‐LT) Registry between March 2011 and November 2013 were considered. Criteria for LCZ696 based on EMA/FDA label, PARADIGM‐HF and ESC guidelines were applied. Of 5443 patients, 2197 and 2373 had complete information for trial and guideline eligibility assessment, and 84%, 12% and 12% met EMA/FDA label, PARADIGM‐HF and guideline criteria, respectively. Absent PARADIGM‐HF criteria were low natriuretic peptides (21%), hyperkalemia (4%), hypotension (7%) and sub‐optimal pharmacotherapy (74%); absent Guidelines criteria were LVEF>35% (23%), insufficient NP levels (30%) and sub‐optimal pharmacotherapy (82%); absent label criteria were absence of symptoms (New York Heart Association class I). When a daily requirement of ACEi/ARB ≥ 10 mg enalapril (instead of ≥ 20 mg) was used, eligibility rose from 12% to 28% based on both PARADIGM‐HF and guidelines. One‐year heart failure hospitalization was higher (12% and 17% vs. 12%) and all‐cause mortality lower (5.3% and 6.5% vs. 7.7%) in registry eligible patients compared to the enalapril arm of PARADIGM‐HF. Conclusions Among outpatients with HFrEF in the ESC‐EORP‐HFA HF‐LT Registry, 84% met label criteria, while only 12% and 28% met PARADIGM‐HF and guideline criteria for LCZ696 if requiring ≥ 20 mg and ≥ 10 mg enalapril, respectively. Registry patients eligible for LCZ696 had greater heart failure hospitalization but lower mortality rates than the PARADIGM‐HF enalapril group.

Introduction. Thromboprophylaxis remains a significant element in the operative and non-operative treatment of trauma patients due to high risk of thromboembolic incidents. This problem concerns a major part of trauma patients. Objective. The aim of the study is to review and evaluate the efficacy of the pharmacological and non-pharmacological methods of venous thromboembolic (VTE) prophylaxis. Brief state of knowledge. There are a few pharmacological methods of VTE prevention, such as: unfractionated heparin (UFH), low molecular weight heparin (LMWH), vitamin K antagonists (VKA), factor Xa inhibitors and direct thrombin Inhibitor. There are also a couple of non-pharmacological methods: intermittent pneumatic compression and graduated compression stockings. The choice of method should be guided by the type of trauma, patient's health status, and potential contraindications for other methods of prophylaxis. Methods. The authors analyzed recent guidelines and research using the most up-to-date sources. The types of traumas were categorized, and a summary compiled of the best way of VTE prophylaxis for each type of trauma. Recommended methods were also rated with the risk of VTE and haemorrhage. Conclusions. The conclusions show that there are still too few studies and the guidelines extant are unambiguous (ambiguous?). Improvment must be sought for in thromboprophylaxis and toward defining uniform guidelines. Due to the large number of surgeries in the treatment of traumas, there is a need to retain all the guidelines in one article. Every operation is connected with high risk of venous thromboembolism, therefore optimal prophylaxis is crucial.