M7. Effects of the angiotensin receptor–neprilysin inhibitor/sacubitril-valsartan administration on quality of life and outcome in heart failure with reduced ejection fraction: a meta analysis

Improved quality of life is a mayor treatment goal in heart failure. Based on the PARADIGM-HF trial, ARNI was found improved quality of life in heart failure with reduced ejection fraction (HFrEF). The aims of this study are to evaluate the quality of life and outcome patient HFrEF after ARNI administration.

Published scientific articles is searched through PubMed database with inclusion criteria were Randomized Control Trial (RCT) or observational study in the last 10 years (2014 - 2021), the QoL is measured by Kansas City Cardiomyopathy Score (KCCQ). A total of 4 RCTs and 3 observational studies were selected. There was significantly increase in KCCQ Overall Summary score (MD = 2.01 [95% CI, 1.07, 2.96], p < 0.00001). There was also significantly increase in KCCQ physical limitation domain (MD = 1.21[95% CI, 0.12, 2.30], p = 0.03), QoL domain (MD = 2.66[95% CI, 0.64, 4.69], p = 0.010) and social limitation domain (MD = 1.97[95% CI, 0.98, 2.95], p < 0.0001). The relative risk in HFrEF patients for first hospital admission was 0.82 (95% CI, 0.77, 0.87, p < 0.00001) and relative risk for cardiovascular death was 0.81(95% CI, 0.76, 0.87, p < 0.00001). Hypotension was found as significant adverse event after treatment with ARNI (RR = 1.57 [95% CI, 1.41, 1.75], p < 0.00001).

ARNI was found significantly improved quality of life, reduced morbidity and mortality in patient HFrEF compared with control but might causes a serious adverse event such as hypotension. Due to limitation data of adverse event, a further investigation might be needed.