Evidence map›Paper›PMID 33257469›Full record

SynthesisOpen heart2020

Beneficial and harmful effects of sacubitril/valsartan in patients with heart failure: a systematic review of randomised clinical trials with meta-analysis and trial sequential analysis.

Emil Eik Nielsen, Joshua Buron Feinberg, Fan-Long Bu, Michael Hecht Olsen, Ilan Raymond, Frank Steensgaard-Hansen, Janus Christian Jakobsen

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Open heart, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
3.4field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.

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  14. Angiotensin receptor blocker neprilysin inhibitors.World journal of cardiology · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Emil Eik NielsenDepartment of Internal Medicine - Cardiology Section, Holbaek Hospital, Holbaek, Denmark Emil.eik.nielsen@gmail.com.ORCID 0000-0003-1108-9533
Joshua Buron FeinbergDepartment of Internal Medicine - Cardiology Section, Holbaek Hospital, Holbaek, Denmark.
Fan-Long BuBeijing Children's Hospital, Capital Medical University, Beijing, China.
Michael Hecht OlsenDepartment of Internal Medicine - Cardiology Section, Holbaek Hospital, Holbaek, Denmark.
Ilan RaymondDepartment of Internal Medicine - Cardiology Section, Holbaek Hospital, Holbaek, Denmark.
Frank Steensgaard-HansenDepartment of Internal Medicine - Cardiology Section, Holbaek Hospital, Holbaek, Denmark.
Janus Christian JakobsenInstitute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
University of Southern Denmark · DKHolbæk Sygehus · DKCapital Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Current guidelines recommend angiotensin receptor blocker neprilysin inhibitors (ARNI) (sacubitril/valsartan) as a replacement for angiotensin-converting-enzymeinhibitor (ACE-I) in heart failure with reduced ejection fraction (HFrEF) who remain symptomatic despite optimal medical therapy. The effects of ARNIs have not previously been assessed in a systematic review. We searched for relevant trials until October 2019 in CENTRAL, MEDLINE, Embase, LILACS, BIOSIS, CNKI, VIP, WanFang and CBM. Our primary outcomes were all-cause mortality and serious adverse events. We systematically assessed the risks of random errors and systematic errors. PROSPERO registration: CRD42019129336. 48 trials randomising 19 086 participants were included. The ARNI assessed in all trials was sacubitril/valsartan. ACE-I or ARB were used as control interventions. Trials randomising HFrEF participants (27 trials) and heart failure with preserved ejection fraction (HFpEF) participants (four trials) were analysed separately. In HFrEF participants, meta-analyses and Trial Sequential Analyses showed evidence of a beneficial effect of sacubitril/valsartan when assessing all-cause mortality (risk ratio (RR), 0.86; 95% CI, 0.79 to 0.94) and serious adverse events (RR, 0.89; 95% CI, 0.86 to 0.93); and the results did not differ between the guideline recommended target population and HFrEF participants in general. We found no evidence of an effect of sacubitril/valsartan in HFpEF participants. Sacubitril/valsartan compared with either ACE-I or ARB seems to have a beneficial effect in patients with HFrEF. Our results indicate that sacubitril/valsartan might be beneficial in a wider population of patients with heart failure than the guideline recommended target population. Sacubitril/valsartan does not seem to show evidence of a difference compared with valsartan in patients with HFpEF.

Indexed as

AminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug CombinationsGlobal HealthHeart FailureHumansNeprilysinRandomized Controlled Trials as TopicSurvival RateValsartanAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug CombinationsNeprilysinsacubitril and valsartan sodium hydrate drug combinationValsartanheart failureheart failure treatmentrenin-angiotensin system

Identifiers

PMID33257469
PMCPMC7705560
OpenAlexW3109335265

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.