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Comparison of Efficacy and Safety of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction: A Meta-Analysis

The present meta-analysis was conducted to compare the safety and efficacy of angiontensin receptor neprilysin inhibitor (ARNI) with angiotensin receptor blockers (ARBs) and angiotensin-converting-enzyme inhibitors (ACEi) in patients with heart failure with reduced ejection fraction (HFrEF). This me...

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Autores principales: Haseeb, Muhammad Talha, Nouman Aslam, Muhammad, Avanteeka, FNU, Khalid, Umar Abdul Rehman, Zubaer Ahmad, Dewan, Senaratne, Mithum, Almaalouli, Bsher, Hirani, Shamsha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114261/
https://www.ncbi.nlm.nih.gov/pubmed/37090394
http://dx.doi.org/10.7759/cureus.36392
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author Haseeb, Muhammad Talha
Nouman Aslam, Muhammad
Avanteeka, FNU
Khalid, Umar Abdul Rehman
Zubaer Ahmad, Dewan
Senaratne, Mithum
Almaalouli, Bsher
Hirani, Shamsha
author_facet Haseeb, Muhammad Talha
Nouman Aslam, Muhammad
Avanteeka, FNU
Khalid, Umar Abdul Rehman
Zubaer Ahmad, Dewan
Senaratne, Mithum
Almaalouli, Bsher
Hirani, Shamsha
author_sort Haseeb, Muhammad Talha
collection PubMed
description The present meta-analysis was conducted to compare the safety and efficacy of angiontensin receptor neprilysin inhibitor (ARNI) with angiotensin receptor blockers (ARBs) and angiotensin-converting-enzyme inhibitors (ACEi) in patients with heart failure with reduced ejection fraction (HFrEF). This meta-analysis was conducted and reported in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Two authors carried out a scientific literature search on online databases, including EMBASE, PubMed, and the Cochrane Library. The following keywords or corresponding Medical Subject Headings (MeSH) were used for the search of relevant articles: “heart failure with reduced ejection fraction,” “angiotensin receptor-neprilysin inhibitor,” “Angiotensin receptor blockers,” and “clinical outcomes.” Outcomes assessed in the present meta-analysis included changes in ejection fraction (EF) from baseline in percentage. Other outcomes assessed in the present meta-analysis included all-cause mortality, cardiovascular death, and hospitalization due to heart failure. Adverse events assessed in the present meta-analysis included hypokalemia, acute kidney injury, and hypotension. Total 10 studies were included. This meta-analysis showed that treatment with ARNI was associated with a significantly lower risk of all-cause mortality and cardiovascular death compared to control groups. There was no significant difference between the two groups in terms of change of EF from baseline or hospitalization related to heart failure. However, the risk of hypotension was significantly higher in patients receiving ARNI. The study findings support the use of ARNI as first-line therapy for heart failure with reduced ejection fraction. Further studies are required to determine the optimal use of ARNI in heart failure management and to investigate the mechanisms underlying the increased risk of hypotension.
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spelling pubmed-101142612023-04-20 Comparison of Efficacy and Safety of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction: A Meta-Analysis Haseeb, Muhammad Talha Nouman Aslam, Muhammad Avanteeka, FNU Khalid, Umar Abdul Rehman Zubaer Ahmad, Dewan Senaratne, Mithum Almaalouli, Bsher Hirani, Shamsha Cureus Cardiology The present meta-analysis was conducted to compare the safety and efficacy of angiontensin receptor neprilysin inhibitor (ARNI) with angiotensin receptor blockers (ARBs) and angiotensin-converting-enzyme inhibitors (ACEi) in patients with heart failure with reduced ejection fraction (HFrEF). This meta-analysis was conducted and reported in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Two authors carried out a scientific literature search on online databases, including EMBASE, PubMed, and the Cochrane Library. The following keywords or corresponding Medical Subject Headings (MeSH) were used for the search of relevant articles: “heart failure with reduced ejection fraction,” “angiotensin receptor-neprilysin inhibitor,” “Angiotensin receptor blockers,” and “clinical outcomes.” Outcomes assessed in the present meta-analysis included changes in ejection fraction (EF) from baseline in percentage. Other outcomes assessed in the present meta-analysis included all-cause mortality, cardiovascular death, and hospitalization due to heart failure. Adverse events assessed in the present meta-analysis included hypokalemia, acute kidney injury, and hypotension. Total 10 studies were included. This meta-analysis showed that treatment with ARNI was associated with a significantly lower risk of all-cause mortality and cardiovascular death compared to control groups. There was no significant difference between the two groups in terms of change of EF from baseline or hospitalization related to heart failure. However, the risk of hypotension was significantly higher in patients receiving ARNI. The study findings support the use of ARNI as first-line therapy for heart failure with reduced ejection fraction. Further studies are required to determine the optimal use of ARNI in heart failure management and to investigate the mechanisms underlying the increased risk of hypotension. Cureus 2023-03-20 /pmc/articles/PMC10114261/ /pubmed/37090394 http://dx.doi.org/10.7759/cureus.36392 Text en Copyright © 2023, Haseeb et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Haseeb, Muhammad Talha
Nouman Aslam, Muhammad
Avanteeka, FNU
Khalid, Umar Abdul Rehman
Zubaer Ahmad, Dewan
Senaratne, Mithum
Almaalouli, Bsher
Hirani, Shamsha
Comparison of Efficacy and Safety of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction: A Meta-Analysis
title Comparison of Efficacy and Safety of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction: A Meta-Analysis
title_full Comparison of Efficacy and Safety of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction: A Meta-Analysis
title_fullStr Comparison of Efficacy and Safety of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction: A Meta-Analysis
title_full_unstemmed Comparison of Efficacy and Safety of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction: A Meta-Analysis
title_short Comparison of Efficacy and Safety of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction: A Meta-Analysis
title_sort comparison of efficacy and safety of angiotensin receptor-neprilysin inhibitors in patients with heart failure with reduced ejection fraction: a meta-analysis
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114261/
https://www.ncbi.nlm.nih.gov/pubmed/37090394
http://dx.doi.org/10.7759/cureus.36392
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