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The effects of sacubitril/valsartan on heart failure with preserved ejection fraction: a meta-analysis

Jiao Yuheng1, Li Yanyan1, Zhang Song1

  • 1Department of Cardiovascular Diseases, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P.R. China.

Acta Cardiologica
|August 12, 2021
PubMed

Insights

Sacubitril/Valsartan reduced heart failure hospitalizations in patients with preserved ejection fraction heart failure (HFpEF). However, it did not significantly improve mortality or NYHA class, and increased hypotension risk.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Heart failure with preserved ejection fraction (HFpEF) remains a therapeutic challenge.
  • Sacubitril/Valsartan has shown promise in heart failure, but its efficacy in HFpEF is debated.

Approach:

  • A systematic review and meta-analysis of randomized controlled trials was conducted.
  • Searches included PubMed, Embase, Web of Science, Cochrane Library, and Clinicaltrials.gov up to December 7, 2020.
  • Four studies with 7739 participants were included.

Key Points:

  • Sacubitril/Valsartan significantly reduced HF hospitalization rates in HFpEF patients (RR: 0.85, 95% CI: 0.79-0.93).
  • No significant benefits were observed for all-cause mortality, cardiovascular mortality, or NYHA class improvement.
  • Increased risk of symptomatic hypotension was noted (RR: 1.44, 95% CI: 1.25-1.66), but no increased risk of renal dysfunction or hyperkalemia.

Conclusions:

  • Sacubitril/Valsartan is effective in reducing HF hospitalizations for HFpEF patients compared to valsartan or individualized medical therapy.
  • While not improving mortality or functional class, its hospitalization benefit warrants consideration in HFpEF management.
Abstract

Keywords:
Heart Failure With Preserved Ejection Fraction (HFpEF)LCZ696Sacubitril/valsartanmeta-analysis

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