Heart failure & cardiomyopathies
Sacubitril-Valsartan vs Enalapril in Heart Failure Due to Chagas Disease: Primary Results of ANSWER-HF Randomized Trial
Primary result · Change in LVEFResult — go to the resultBetween-group difference 0.9 percentage points 95% CI −0.9 to 2.6Authors' conclusion
In patients with CCC and HFrEF, sacubitril-valsartan did not result in significant improvements in LVEF compared with enalapril after 6 months, but was associated with a greater reduction in NT-proBNP.
Study context
- Population
- Patients with chronic Chagas cardiomyopathy and heart failure with reduced ejection fraction (HFrEF) (LVEF <40%, NYHA class II–IV), Brazilrandomised 1:1
- Participants
- 190 patients
- Comparison
- Sacubitril-valsartan vs enalapril
- Primary endpoint
- Change in LVEF from baseline
- Follow-up
- 6 months
Methodological detailsdouble-blind
- Double-blind
Primary result
Change in LVEF
Between-group difference
0.9 percentage points
95% CI −0.9 to 2.6
P = 0.36
Change by group
Sacubitril-valsartan
2.1%
mean increase
Enalapril
1.2%
mean increase
Sacubitril-valsartan vs Enalapril
between-group difference 0.9 percentage points (95% CI −0.9 to 2.6); P = 0.36
As reported in the abstract
Secondary outcomes
| Outcome | Win ratio (95% CI) | P value | |
|---|---|---|---|
| Hierarchical endpoint (CV death, HF hospitalisation, NT-proBNP change, LVEF change), win ratio | 1.80 (1.27–2.63) | ||
| 0.20.5125Win ratio (log scale) |
| Outcome | Geometric mean ratio (95% CI) | P value | |
|---|---|---|---|
| NT-proBNP | 0.68 (0.57–0.81) | P < 0.001 | |
| 0.512Geometric mean ratio (log scale) |
Echocardiographic remodeling, 6-minute walk distance
- No significant differences
Safety
Safety outcomes
- Occurrence of safety outcomes comparable
Original publication
Sacubitril-Valsartan vs Enalapril in Heart Failure Due to Chagas Disease: Primary Results of ANSWER-HF Randomized Trial. J Am Coll Cardiol. Published 9 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it