Sacubitril/valsartan showed comparable efficacy to enalapril with no significant difference in hospitalization for heart failure (RR 0.93; 95% CI 0.74-1.16; P=0.53) in Chagas cardiomyopathy HFrEF.
Meta-Analysis (n=1,225)
Does sacubitril/valsartan reduce hospitalization for heart failure, cardiovascular mortality, or all-cause mortality compared to enalapril in patients with HFrEF due to Chagas cardiomyopathy?
Sacubitril/valsartan demonstrates comparable efficacy and safety to enalapril in patients with HFrEF secondary to Chagas cardiomyopathy.
Effect estimate: RR 0.93 (95% CI 0.74-1.16)
p-value: p=0.53
Chagas cardiomyopathy represents a distinct and understudied etiology of heart failure with reduced ejection fraction (HFrEF). This meta-analysis aims to compare the efficacy and safety of sacubitril/valsartan versus enalapril in the treatment of patients with HFrEF due to Chagas cardiomyopathy with a total of 1225 patients (615 in the sacubitril/valsartan group and 610 in the enalapril group). There were no statistically significant differences between sacubitril/valsartan and enalapril in hospitalization for heart failure risk ratios (RR) = 0.93; 95% confidence intervals (CI), 0.74–1.16; P = 0.53, cardiovascular mortality (RR = 0.91; 95% CI, 0.73–1.12; P = 0.37), or all-cause mortality (RR = 0.96; 95% CI, 0.79–1.17; P = 0.69). Heterogeneity was low across all efficacy outcomes ( I 2 = 0–4.1%). Similarly, we found no significant differences in safety outcomes, including symptomatic hypotension (RR = 1.14; 95% CI, 0.94–1.39), kidney dysfunction (RR = 1.08; 95% CI, 0.84–1.39), or hyperkalemia (RR = 1.26; 95% CI, 0.37–4.32). Our results indicated that sacubitril/valsartan has comparable efficacy to enalapril with no significant differences in hospitalization for heart failure, cardiovascular mortality, or all-cause mortality in patients with HFrEF secondary to Chagas cardiomyopathy.
AlSejari et al. (Mon,) conducted a meta-analysis in HFrEF due to Chagas cardiomyopathy (n=1,225). sacubitril/valsartan vs. enalapril was evaluated on hospitalization for heart failure (RR 0.93, 95% CI 0.74-1.16, p=0.53). Sacubitril/valsartan showed comparable efficacy to enalapril with no significant difference in hospitalization for heart failure (RR 0.93; 95% CI 0.74-1.16; P=0.53) in Chagas cardiomyopathy HFrEF.