| Abstrakt: |
Introduction:Sacubitril-Valsartan is an angiotensin receptor neprilysin inhibitor (ARNI) associated with a decreased risk of death and of hospitalization for heart failure. However, its effects on atherosclerotic disease outcomes are not definitively known.Methods:We performed a systematic review and meta-analysis comparing the effects of ARNI with angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) on acute coronary syndrome (ACS), myocardial infarction (MI), stroke, angina pectoris and peripheral artery disease (PAD). PubMed, Scopus and Cochrane Central were searched for randomized studies until June 2022.Results:Thirteen randomized controlled trials, with 20,981 patients were included; 10,483 (50%) patients received ARNI and 10,498 were treated with ACEI or ARB (50%). The incidence of MI (OR 0.96; 95% CI 0.79-1.16; p=0.62; Fig. 1A), ACS (OR 0.98; 95% CI 0.61-1.59; p=0.97; Fig. 1B), angina pectoris (OR 0.95; 95% CI 0.78-1.15; p=0.58) and stroke (OR 1.00; 95% CI 0.85-1.17; p=0.96) were not statistically different between groups. However, ARNI was associated with higher incidence of PAD (OR 1.60; 95% CI 1.03-2.47; p=0.04; Fig. 2).Conclusions:There was no significant difference between ARNI and ACEI or ARB in terms of ACS, MI, angina pectoris, or stroke, although there was a slightly higher incidence of PAD in patients treated with ARNI. |
