Heart failure & cardiomyopathies
Sacubitril/Valsartan vs ACE Inhibitors or Angiotensin Receptor Blockers (ARBs): A Systematic Review and Meta-Analysis of Randomized Trials
Primary result · All-cause mortality, EF ≤40%Result — go to the resultRelative risk 0.88 95% CI 0.81–0.94Authors' conclusion
The SAV-treated group, across all EF spectrum, was less likely to be rehospitalized than the ACEI/ARB-treated group. However, all-cause mortality reduction was only noted in the SAV group with EF <40%. No reduction in CV-related mortality was observed across the EF spectrum.
Study context
- Population
- Population with heart failure (HF) treated with sacubitril/valsartan (SAV) vs angiotensin-converting enzyme inhibitors (ACEI)/ARBs
- Participants
- 25,167 participants · 14 trials
- Comparison
- SAV vs ACEI/ARBs
Methodological detailsRandom effect model
- Random effect model
Primary result
All-cause mortality, ejection fraction (EF) ≤40%
Relative risk
0.88
95% CI 0.81–0.94
P = 0.0006
SAV vs ACEI/ARB
RR 0.88 (95% CI 0.81–0.94); P = 0.0006
As reported in the abstract
Further findings
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality, EF >40% | 0.97 (0.85–1.11) | P = 0.67 | |
| CV mortality across EF spectrums | 0.9 (0.79–1.03) | P = 0.13 | |
| HF readmission regardless of EF · lower in the SAV-treated group | 0.85 (0.79–0.91) | P = 0.00001 | |
| 0.512Relative risk (log scale) |
Original publication
Sacubitril/Valsartan vs ACE Inhibitors or ARBs: A Systematic Review and Meta-Analysis of Randomized Trials. JACC Adv. Published 18 February 2025. doi:10.
Summarised from the published abstract; every number is checked against it