Sacubitril/valsartan vs Enalapril in acute heart failure

A recent study compared the safety and efficacy of valsartan/sacubitril (angiotensin receptor neprilysin inhibitor [ARNI]) against enalapril (angiotensin-converting enzyme inhibitor [ACEI]) in patients with acute heart failure at 6-month follow-up. The study is published in Indian Heart Journal.

The study was a prospective, single centre, and observational study where patients with acute decompensated heart failure with reduced ejection fraction were included. Patients were divided in two groups: valsartan/sacubitril (ARNI) group and enalapril (ACEI). Patients were followed up for at least 6 months after administration of first dose and were evaluated for safety, efficacy, and tolerability of target drug.

A total of 200 patients were included in the present study,100 each in angiotensin receptor neprilysin inhibitor and angiotensin-converting enzyme inhibitor group. The mean maximum tolerated dose by population in angiotensin receptor neprilysin inhibitor group was 203.6 mg and 8.9 mg in angiotensin-converting enzyme inhibitor group. Re- admission for heart failure were seen significantly higher in angiotensin-converting enzyme inhibitor group than angiotensin receptor neprilysin inhibitor group. Parameters like ejection fraction, left ventricular end diastolic and systolic dimensions, 6 min walk test and Kansas City Cardiomyopathy Questionnaires (KCCQ) were also looked into.

Therefore, the researchers concluded that the angiotensin receptor neprilysin inhibitor study group showed better safety and efficacy outcomes at the end of 6 months follow-up compared to angiotensin-converting enzyme inhibitor group.

Reference:

Tahir Saleem Bhat, Imran Hafeez, Sobia Fatima Tak, "Safety and efficacy of ARNI (valsartan/sacubitril) vs ACEI (enalapril) in acute heart failure e A prospective observational study" ;https://doi.org/10.1016/j.ihj.2022.04.003.