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The Efficacy of Sacubitril/Valsartan (ARNI) in Decreasing Mortality Among Heart Failure Patients: A Systematic Review

Hashim Talib Hashim1, Mohammedbaqer Ali Al-Ghuraibawi2, Muhammad Hassan Hafeez3

  • 1Department of research, University of Warith Al-Anbiyaa, College of Medicine, Karbala, Iraq.

Current Cardiology Reviews
|March 13, 2026
PubMed

Insights

Sacubitril/Valsartan significantly reduces NT-proBNP levels and disease events in chronic heart failure (CHF) patients. While effective, monitor for hypotension, as it was the most common adverse event.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Chronic heart failure (CHF) is a major cause of mortality and morbidity worldwide.
  • Sacubitril/Valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), shows promise in improving CHF outcomes.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy and safety of Sacubitril/Valsartan versus conventional therapies in CHF patients.

Main Methods:

  • Systematic review following PRISMA 2020 guidelines, searching PubMed, Scopus, and Web of Science.
  • Included 10 randomized controlled trials (15,650 patients) comparing Sacubitril/Valsartan with standard therapies.
  • Meta-analyses assessed pooled outcomes, including NT-proBNP levels, disease events, and adverse events.

Main Results:

  • Sacubitril/Valsartan significantly reduced NT-proBNP levels (SMD = -0.30, p = 0.03) and disease-related events (OR = 0.82, p < 0.00001).
  • Hypotension was the most frequent adverse event (OR = 1.57, p < 0.0001).
  • No significant differences in hyperkalemia or renal dysfunction compared to controls.

Conclusions:

  • Sacubitril/Valsartan improves outcomes and reduces mortality/morbidity in CHF patients.
  • The drug has an acceptable safety profile, with hypotension being the primary concern.
  • Sacubitril/Valsartan is an effective therapeutic option for managing CHF.
Abstract

Keywords:
Sacubitril/valsartanchronic heart failure (CHF)meta-analysissacubitril.systematic review

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