Does sacubitril/valsartan improve outcomes compared to enalapril consistently across different etiologies in patients with HFrEF?
The clinical benefit of sacubitril/valsartan over enalapril in HFrEF is consistent regardless of the underlying heart failure etiology.
Just under one-half of patients in this global trial had nonischemic HF with reduced ejection fraction, with idiopathic and hypertensive the most commonly ascribed etiologies. Adjusted outcomes were similar across etiologic categories, as was the benefit of sacubitril/valsartan over enalapril. (Efficacy and Safety of LCZ696 Compared to Enalapril on Morbidity and Mortality of Patients With Chronic Heart Failure; NCT01035255).
Balmforth et al. (2019) studied this question.