AIM To systematically evaluate the efficacy and safety of LCZ696 (sacubitril-valsartan) in the treatment of heart failure with preserved ejection fraction (HFpEF), and to provide clinical basis for treatment.
METHODS The Cochrane Library, PubMed, Embase, CNKI, Wanfang database, VIP and China Biomedical Literature Service system were searched for literatures on LCZ696 for HFpEF from the date of the establishment of each database to August 2020. Literature screening and quality evaluation were carried out strictly according to the inclusion and exclusion criteria. All outcome indexes were conducted the meta-analysis by Revman5.3 software.
RESULTS A total of 5 RCTs studies were selected, involving 5313 patients. The results of combined outcome indexes showed that the levels of NT-pro BNP SMD = −3.29, 95%CI(−6.40, −0.19), P = 0.04, 6MWT WMD = 84.25, 95%CI(24.95, 143.55), P<0.01, HF re-hospitalization rate RR = 0.85, 95%CI(0.78, 0.92), P<0.01, and renal injuryRR = 0.50, 95%CI(0.34, 0.75), P<0.01 in trial group were significantly improved. There were no statistical significance in the incidence of hyperkalemiaRR=0.90, 95%CI(0.78, 1.03), P = 0.12, LVEFWMD=0.43, 95%CI(−0.14, 1.00), P = 0.14 and E/e’WMD = −1.71, 95%CI(−4.18, 0.77), P = 0.18 after treatment, and all-cause mortalityRR = 0.97, 95%CI(0.85, 1.11), P = 0.66 between 2 groups. The incidence of symptomatic hypotensionRR = 1.43, 95%CI(1.24, 1.64), P<0.01 in trial group was higher than control group.
CONCLUSIONS LCZ696 effectively improves the level of NT-pro BNP, 6MWT and re-hospitalization rate in the patients of HFpEF, and it does not increase the risk of renal injury and hyperkalemia.
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