Heart failure & cardiomyopathies
Angiotensin Receptor-Neprilysin Inhibitors in Concurrent Heart Failure with Reduced Ejection Fraction and Kidney Failure
Main findingResult — go to the resultHazard ratio 0.86 95% CI 0.75–0.97Authors' conclusion
Among HFrEF patients with kidney failure receiving replacement therapy, ARNI use was associated with lower risks of all-cause mortality, any hospitalization and cardiovascular mortality compared with RAS blockers, particularly in those with good adherence to therapy.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) and kidney failure receiving replacement therapy, Korean National Health Insurance Service database, 2017–2021after IPTW weighting
- Participants
- 2,104 vs 2,191
- Exposure
- Angiotensin receptor-neprilysin inhibitor (ARNI) vs renin-angiotensin system (RAS) blockers
- ARNIn = 2,104
- RAS blockersn = 2,191reference
- Outcome
- Composite of:
- All-cause mortality
- Any hospitalization
- Follow-up
- Median 19.1 months
Methodological detailsinverse probability of treatment weighting, nationwide claims database
- Inverse probability of treatment weighting
- Nationwide claims database
Main finding
As reported in the abstract
Hazard ratio
0.86
95% CI 0.75–0.97
ARNIvs RAS blockers
HR 0.86 (95% CI 0.75–0.97)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause mortality | 0.68 (0.54–0.86) | |
| Any hospitalization | 0.86 (0.75–0.98) | |
| CV mortality | 0.68 (0.52–0.89) | |
| 0.512Hazard ratio (log scale) |
Primary endpoint by subgroup (age, sex, comorbidities, medications)
- Consistent associations across subgroups
Primary endpoint by ARNI adherence
- Good adherence linked to lower risk; non-adherence showed no benefit
Original publication
Angiotensin Receptor-Neprilysin Inhibitors in Concurrent Heart Failure with Reduced Ejection Fraction and Kidney Failure. ESC Heart Fail. Published 3 July 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →