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July 28, 2020ESC Heart FailureOpen Access

Sacubitril/valsartan was superior to ARB therapy in reducing the composite of cardiovascular death and hospitalization for worsening HF (HR 0.74; 95% CI 0.57-0.96).

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Why the study?

The study aimed to compare the efficacy of ARNI therapy with ARB therapy for cardiovascular outcomes in real-world patients with heart failure with reduced ejection fraction.

Does sacubitril/valsartan reduce the composite of cardiovascular death and hospitalization for worsening heart failure compared to ARB therapy in patients with HFrEF?

Population

Patients with heart failure with reduced ejection fraction from the Chang Gung Research Database

Comparison

ARNI therapy vs ARB therapy

Design

Retrospective propensity score-matched cohort study

Key result

Sacubitril/valsartan was superior to ARB therapy in reducing the composite of cardiovascular death and hospitalization for worsening HF (HR 0.74; 95% CI 0.57-0.96).

Authors

PCPo‐Cheng ChangCWChun‐Li WangFHFu‐Chih Hsiao

Discussion

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Overview

ARNI was associated with lower CV risk than ARB in HFrEF; extends observational support but leaves randomized confirmation open.

Study Design

Type

Cohort

Structured PICO

Does sacubitril/valsartan reduce the composite of cardiovascular death and hospitalization for worsening heart failure compared to ARB therapy in patients with HFrEF?

P
Population
Patients with heart failure with reduced ejection fraction from a real-world database in Taiwan.
E
Exposure
Sacubitril/valsartan (angiotensin receptor-neprilysin inhibitor therapy)
C
Comparator
Angiotensin receptor blocker (ARB) therapy
O
Outcome
Composite of cardiovascular death and hospitalization for worsening heart failurecomposite

Main Result

Hazard Ratio: 0.74 (95% CI 0.57–0.96)

In a real-world Taiwanese cohort of HFrEF patients, sacubitril/valsartan significantly reduced the composite of cardiovascular death and heart failure hospitalization compared to ARB therapy, despite the use of lower-than-trial doses.

Cite This Study

Chang et al. (2020) conducted a cohort in Heart failure with reduced ejection fraction. Sacubitril/valsartan vs. Angiotensin receptor blocker (ARB) therapy was evaluated on Composite of cardiovascular death and hospitalization for worsening HF (HR 0.74, 95% CI 0.57-0.96). Sacubitril/valsartan was superior to ARB therapy in reducing the composite of cardiovascular death and hospitalization for worsening HF (HR 0.74; 95% CI 0.57-0.96).

synapsesocial.com/papers/6a6586cd200d52e596c07f5dhttps://doi.org/10.1002/ehf2.12924
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Randomized Trial of the Angiotensin-Receptor Blocker Valsartan in Chronic Heart Failure2001 · 3,117 citations
  2. 2Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure2014 · 6,987 citations
  3. 3Valsartan, Captopril, or Both in Myocardial Infarction Complicated by Heart Failure, Left Ventricular Dysfunction, or Both2003 · 2,493 citations
  4. 4TSOC-HFrEF Registry: A Registry of Hospitalized Patients with Decompensated Systolic Heart Failure: Description of Population and Management.2016 · 75 citations
  5. 52013 ACCF/AHA Guideline for the Management of Heart Failure2013 · 12,633 citations