Sacubitril-valsartan not tied to lower death risk versus ramipril in acute myocardial infarction: Study
USA: A recent study suggests that in patients with acute myocardial infarction, sacubitril-valsartan did not significantly lower death risk from cardiovascular causes or incident heart failure versus ramipril. The study appears in the New England Journal of Medicine.
Previous trials have shown sacubitril–valsartan to reduce the risk of hospitalization and death from cardiovascular causes in patients with symptomatic heart failure more effectively than an angiotensin-converting–enzyme inhibitor. However, trials comparing the effects of these drugs in patients with acute myocardial infarction are lacking. To fill this knowledge gap Marc A. Pfeffer and the team aimed to compare the effects of these drugs in patients with acute myocardial infarction.
The study included patients with myocardial infarction complicated by a reduced left ventricular ejection fraction, pulmonary congestion, or both. 5661 patients were randomly assigned to receive either sacubitril–valsartan (97 mg of sacubitril and 103 mg of valsartan twice daily; n=2830) or ramipril (5 mg twice daily; n=2831) in addition to recommended therapy. The primary outcome was death from cardiovascular causes or incident heart failure (outpatient symptomatic heart failure or heart failure leading to hospitalization), whichever occurred first.
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