The in-hospital administration of sacubitril/valsartan in acute myocardial infarction: A meta-analysis

• Published in: ESC Heart Failure 2024-10
• Main Authors: Di Pietro, Gianluca, Improta, Riccardo, Severino, Paolo, D'Amato, Andrea, Birtolo, Lucia Ilaria, De Filippo, Ovidio, Lattanzio, Antonio, De Cristofaro, Raffaele, Galardo, Giacchino, D'Ascenzo, Fabrizio, Badagliacca, Roberto, Sardella, Gennaro, Volterrani, Maurizio, Fedele, Francesco, Vizza, Carmine Dario, Mancone, Massimo
• Format: Article
• Language: English
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.15082

There is a need to address the evidence gap regarding the in-hospital administration of sacubitril/valsartan in acute myocardial infarction patients. After searching MEDLINE, Google Scholars and Scopus, a random-effects meta-analysis of randomized controlled trials comparing the in-hospital administration of the angiotensin receptor-neprilysin inhibitors (ARNis) versus the standard therapy in patients with reduced heart failure due to myocardial infarction was performed. The primary outcome was major adverse cardiovascular events. All-cause mortality, cardiac death, rehospitalization for heart failure, non-fatal myocardial infarction (MI), changes in left ventricular ejection fraction, left ventricular volumes, N terminal pro brain natriuretic peptide and adverse events were the secondary endpoints. Nine studies (eight randomized controlled trials and one echo-substudy) with a total 6597 individuals (angiotensin-converting enzyme inhibitor/angiotensin receptor blocker: 3300 patients vs. ARNis: 3297 patients) were included for quantitative analysis. Median follow-up was 6 months. Patients receiving an in-hospital coadministration of ARNi had a lower risk of major cardiovascular event [odds ratio (OR) 0.45, 95% confidence interval (CI) 0.32-0.63, P