| Objective:This meta-analysis was conducted to investigate the efficacy and safety of Sacubitril Valsartan in the treatment of heart failure.Methods:All the relevant studies were searched from Pubmed?Embase?Cochrane Library from the databases establishment to March 6,2020.Two resrarchers screened litertures according to inclusion and exclusion criteria,then extracted data and evaluated quality.Statistical analyses were performed using Revman 5.3 and Stata 15.0.Results:A total of 7243 patients of 5 studies were enrolled,with heart failue treated with Sacubitril Valsartan,all of which were prospective randomized controlled trials(RCTs),and control group were angiotensinconverting enzyme inhibitors(ACEI)or angiotensin II receptor blockers(ARB).Meta-analysis results showed that Sacubitril Valsartan significantly reduced the risk of re-hospitalization for patiens with heart failure [RR=0.80,95%CI(0.71,0.91),P<0.01].Subgroup analysis showed that Sacubitril Valsartan significantly reduced the risk of cardiovascular death [RR=0.81,95%CI(0.73,0.90),P<0.01] and all-cause mortality [RR=0.85,95%CI(0.78,0.93),P=0.001] in patients with heart failure with reduced ejection fraction(HFrEF).In terms of the occurrence of adverse events,compared with ACEI/ARB,Sacubitril Valsartan increased the incidence of hypotension and reduced the incidence of renal impairment in patients with heart failure with preserved ejection fraction(HFpEF),but there were no difference in HFrEF? The other adverse events such as angioedema and hyperkalemia,there were no significantly increased in either HFrEF or HFpEF patients.Conclusion:The results of meta-analysis showed that in the treatment of patients with heart failure,compared with ACEI/ARB,Sacubitril Valsartan not only significantly reduced the risk of re-hospitalization in all group and the risk of cardiovascular death and all-cause mortailty in HFrEF patients,but also reduced the risk of renal impairment in HFpEF patients. |
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