Key result
ARNI treatment was associated with a lower risk of worsening heart failure or all-cause mortality compared with RAS blockade alone in older adults with HFrEF (HR 0.84; 95% CI 0.80 to 0.89).
Why the study?
To evaluate the effectiveness of ARNI versus RAS blockade alone in older adults with HFrEF in clinical care.
Does angiotensin receptor-neprilysin inhibitor (ARNI) reduce the composite of worsening heart failure or all-cause mortality compared to RAS blockade alone in older adults with HFrEF?
Cohort (n=51,208)
Does angiotensin receptor-neprilysin inhibitor (ARNI) reduce the composite of worsening heart failure or all-cause mortality compared to RAS blockade alone in older adults with HFrEF?
Effect estimate: HR 0.84 (95% CI 0.80 to 0.89)
In older adults with HFrEF in routine clinical care, ARNI treatment is associated with a significantly lower risk of worsening heart failure or all-cause mortality compared to RAS blockade alone.
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ARNI may inform prescribing decisions in older HFrEF patients; extends trial data to routine care but leaves causal confirmation open.
Desai et al. (2021) conducted a cohort in heart failure with reduced ejection fraction (HFrEF) (n=51,208). Angiotensin receptor-neprilysin inhibitor (ARNI) vs. Renin-angiotensin system (RAS) blockade alone was evaluated on composite outcome of time to first worsening heart failure event or all-cause mortality (HR 0.84, 95% CI 0.80 to 0.89). ARNI treatment was associated with a lower risk of worsening heart failure or all-cause mortality compared with RAS blockade alone in older adults with HFrEF (HR 0.84; 95% CI 0.80 to 0.89).
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