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2022 (Medical sciences) 34
34. A 55 year old male taking perindopril is switched to sacubitril/valsartan. What biochemical finding will be elevated post commencing sacubitril/valsartan?
  1. ADH
  2. BNP
  3. NT-proBNP
  4. Troponin
  1. ADH
  2. BNP
  3. NT-proBNP 
  4. Troponin
Sacubitril: An angiotensin receptor neprilysin inhibitor (ARNi) that inhibits neprilysin, an enzyme responsible for breaking down natriuretic peptides, including BNP and NT-proBNP. BNP helps counteract the effects of heart failure through its natriuretic, diuretic, and vasodilatory actions.
NT-proBNP is the inactive fragment produced when proBNP is cleaved into BNP NT-proBNP. 
NT-proBNP has a longer half life (up to 2hrs) cf to BNP which has half life of 20 minutes. 

Valsartan: An angiotensin II receptor blocker (ARB) that helps reduce the effects of angiotensin II on blood pressure and heart remodeling
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