Meta-analysis Of Renal Protective Effects Of LCZ696 In Patients With Heart Failure

Objective:META analysis was used to evaluate whether sacubitril and valsartan(LCZ696)is more effective in delaying the further deterioration of renal function in patients with heart failure compared with renin-angiotensin system(RAS)inhibitors alone.Methods:We search for relevant research in online databases such as PUBMED,EMBASE,MEDLINE and Cochrane libraries,screen articles according to inclusion and exclusion criteria,extract data and evaluate quality,and use stata12.0 software for Meta analysis.Results:A total of 4485 related articles were retrieved.After selection,10 articles met our inclusion criteria and were included,with a total of 28657 subjects.In 4 studies,the comparative drugs were ACEI,and in 6 studies,the comparative drugs were ARB.Most studies focused on patients with heart failure(nude 8),with five studies with ejection fraction less than 40% and three studies with ejection fraction more than 45%.Compared with RAS inhibitors alone,LCZ696 has a lower risk of worsening renal function [OR=0.767(95% IC 0.624-0.942),OR= 0.011].Compared with HF patients with ejection fraction less than 40%,HF patients with more than 40% ejection fraction had a lower risk of renal deterioration.For the type of RAS contrast agents,there was no difference in the risk of kidney deterioration compared with ACEI drugs and ARB drugs.The risk of renal deterioration decreased with the increase of age,and the higher the proportion of women,the lower the risk of renal deterioration,but the follow-up time had no significant effect.Conclusion:Compared with renin-angiotensin system(RAS)inhibitors alone,sacubitril and valsartan(LCZ696)has advantages in delaying the further deterioration of renal function in patients with heart failure.