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May 26, 2025Future CardiologyOpen Access

ARNIs significantly reduced major adverse cardiovascular events (RR: 0.66, 95% CI [0.50, 0.86]; p = 0.002) compared to ACEIs.

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Why the study?

Although ACEIs remain the cornerstone treatment for STEMI, ARNIs may offer better outcomes, prompting a comparison of their efficacy and safety.

Do angiotensin-receptor neprilysin inhibitors (ARNIs) reduce major adverse cardiovascular events compared to ACE inhibitors in patients with STEMI?

Comparison

ARNIs vs ACEIs

Design

Systematic review and meta-analysis of RCTs

Authors

AAAymen AhmedInterventional / Structural CardiologyMSMuhammad Umer SohailRiphah International UniversityMSMuhammad SaadSilesian University of Technology

Discussion

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Member takes

Overview

May support ARNI preference over ACEIs post-STEMI with hypotension monitoring; extends randomized HF evidence to acute MI.

Structured PICO

Do angiotensin-receptor neprilysin inhibitors (ARNIs) reduce major adverse cardiovascular events compared to ACE inhibitors in patients with STEMI?

P
Population
4,915 patients with ST-segment elevation myocardial infarction (STEMI) pooled from 5 randomized controlled trials
I
Intervention
Angiotensin-receptor neprilysin inhibitors (ARNIs)
C
Comparator
Angiotensin-converting enzyme inhibitors (ACEIs)
O
Outcome
Major adverse cardiovascular events (MACE)composite

In patients with STEMI, ARNI therapy significantly reduces MACE and heart failure hospitalizations while improving LVEF compared to ACE inhibitors, though with an increased risk of hypotension.

Cite This Study

Ahmed et al. (2025) studied this question.

synapsesocial.com/papers/6a8a6c3c439f8b7e01434e1ehttps://doi.org/10.1080/14796678.2025.2506350
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Also Consider

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

  1. 1Efficacy and safety profile of angiotensin receptor neprilysin inhibitors in the management of heart failure: a systematic review and meta-analysis of randomized controlled trials2022 · 7 citations
  2. 2Angiotensin-neprilysin inhibition in acute decompensated heart failure: a meta-analysis of randomized controlled trials2025
  3. 3Angiotensin-neprilysin inhibition in acute decompensated heart failure: a systematic review and meta-analysis of randomized controlled trials2025
  4. 4The Impact of Angiotensin Receptor–Neprilysin Inhibitors on Arrhythmias in Patients with Heart Failure: A Systematic Review and Meta-analysis2022 · 12 citations
  5. 5Comparison of Efficacy and Safety of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction: A Meta-Analysis2023 · 6 citations