AUTHOR=Yu Wanqian , Zhang Hongzhou , Shen Wen , Luo Fan , Yang Shuai , Gan Lujin , Zhao Yuanbin , Yang Pingping , Wu Qinghua 

TITLE=Efficacy and safety of sacubitril/valsartan on heart failure with preserved ejection fraction: A meta-analysis of randomized controlled trials

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.897423

DOI=10.3389/fcvm.2022.897423

ISSN=2297-055X

ABSTRACT=<sec><title>Aims</title><p>The efficacy and safety of sacubitril/valsartan for patients with heart failure with preserved ejection fraction (HFpEF) are controversial. Hence, the primary objective of the study was to evaluate the efficacy and safety of sacubitril/valsartan treatment for patients with HFpEF.</p></sec><sec><title>Methods and results</title><p>We used the PubMed, Embase, and Web of Science databases to search for randomized controlled trials of sacubitril–valsartan in patients with HFpEF. Three studies, involving a total of 7,663 patients, were eligible for inclusion. Sacubitril–valsartan reduced the risk of hospitalization for heart failure (HF) [odds ratio (<italic>OR</italic>): 0.78; 95% <italic>CI</italic>: 0.70–0.88; <italic>p</italic> &lt; 0.0001] and the incidence of worsening renal function [risk ratio (<italic>RR</italic>): 0.79, <italic>p</italic> = 0.002] among patients with HFpEF in the three trials, but there was no significant reduction in all-cause mortality (0.99, 95% <italic>CI</italic>: 0.84–1.15; <italic>p</italic> = 0.86) or cardiovascular mortality (0.95, 95% <italic>CI</italic>: 0.78–1.15; <italic>p</italic> = 0.16). Moreover, sacubitril/valsartan was associated with an increased risk of symptomatic hypotension (<italic>RR</italic>: 1.44; <italic>p</italic> &lt; 0.00001) and angioedema (<italic>RR</italic>: 2.66; <italic>p</italic> &lt; 0.04); there was no difference for decreasing the incidence of hyperkalemia (<italic>RR</italic>: 0.89; <italic>p</italic> = 0.11).</p></sec><sec><title>Conclusion</title><p>Compared with valsartan or individualized medical therapy (IMT), sacubitril/valsartan significantly decreased the risk of hospitalization for HF and reduced the incidence of renal dysfunction.</p></sec>