Key result
In a real-world Swedish cohort of patients with heart failure and ejection fraction <50%, ARNI was associated with a 23% reduction in all-cause mortality compared with ACEi/ARB (HR 0.77).
Why the study?
Sacubitril/valsartan has a class-1 guideline recommendation, but its real-world effectiveness versus ACEi/ARB on mortality and hospitalizations in HF with reduced or mildly reduced ejection fraction needed assessment.
Does sacubitril/valsartan (ARNI) reduce mortality and hospitalizations compared to ACEi/ARB in patients with heart failure with reduced or mildly reduced ejection fraction?
Cohort (n=2,744)
Yes
Does sacubitril/valsartan (ARNI) reduce mortality and hospitalizations compared to ACEi/ARB in patients with heart failure with reduced or mildly reduced ejection fraction?
Hazard Ratio: 0.77 (95% CI 0.63–0.95)
Absolute Event Rate: 7.1% vs 9.3%
p-value: p=0.013
In a real-world Swedish registry, ARNI was associated with a significant reduction in all-cause mortality compared to ACEi/ARB in patients with HFrEF or HFmrEF, consistent with pivotal trial data.
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May support ARNI preference in real-world HFrEF; hypothesis-generating and requires RCT confirmation before practice change.
Fu et al. (2022) conducted a cohort in Heart failure with reduced or mildly reduced ejection fraction (n=2,744). Sacubitril/valsartan (ARNI) vs. ACEi/ARB was evaluated on All-cause mortality (HR 0.77, 95% CI 0.63-0.95, p=0.013). In a real-world Swedish cohort of patients with heart failure and ejection fraction <50%, ARNI was associated with a 23% reduction in all-cause mortality compared with ACEi/ARB (HR 0.77).
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