Sacubitril/valsartan reduces cardiac decompensation in heart failure with preserved ejection fraction: a meta-analysis

BACKGROUND: The impact of sacubitril–valsartan on heart failure (HF) patients with preserved ejection fractions (HFpEF) is uncertain. The purpose of this meta-analysis was to explore the clinical advantages and safety of sacubitril–valsartan in patients with HFpEF. METHODS: PubMed and Web of Science were searched without any restrictions from inception to 8 May 2022 to identify valuable articles. The studies that met the inclusion criteria were analyzed. RESULTS: Four trials, with a total of 7008 patients were included. Compared with valsartan, sacubitril–valsartan significantly reduced the rate of HF decompensation and of the combined end point of HF decompensation and all-cause mortality. All-cause mortality, New York Heart Association class improvement and rate of hyperkalemia were not significantly different between the two groups. Regarding safety, sacubitril–valsartan was more likely to increase the risk of hypotension. CONCLUSION: This meta-analysis suggests that sacubitril–valsartan may be an effective strategy to reduce HF decompensation events in patients with HFpEF. Systematic Review registration: CRD42022336077.