Abstract: PO1805
Renal Outcomes and Safety of Angiotensin Receptor Neprilysin Inhibitors in Patients with Heart Failure: A Meta-Analysis
Session Information
- Hypertension and CVD: Clinical, Outcomes, and Trials
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1402 Hypertension and CVD: Clinical, Outcomes, and Trials
Authors
- Abou arkoub, Rima Nazih, McGill University Health Centre, Montreal, Quebec, Canada
- Mavrakanas, Thomas, McGill University Health Centre, Montreal, Quebec, Canada
- Bergeron, Amy, McGill University Health Centre Glen Site McConnell Resource Centre Medical Library, Montreal, Quebec, Canada
- Sharma, Abhinav, McGill University Health Centre, Montreal, Quebec, Canada
- Alam, Ahsan, McGill University Health Centre, Montreal, Quebec, Canada
Background
Angiotensin receptor neprilysin inhibitors (ARNIs) are an effective treatment for heart failure. However, their safety profile compared with angiotensin converting enzyme-inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) with respect to renal outcomes has not been clearly established.
Methods
We conducted a literature search of MEDLINE, Cochrane library, Embase, and clinical trials registries using relevant search terms (last search date May 7, 2021). The primary renal outcome was kidney function decline and the safety outcome was hyperkalemia. Only studies with at least 12 weeks of follow up were included in the renal outcome analysis to better capture CKD.
Results
Ten randomized controlled trials were eligible for inclusion (n=22,174 participants). ARNIs were associated with a lower risk of kidney function decline compared with ACEIs or ARBs: RR 0.65 (95%CI 0.53-0.81). The risk of hyperkalemia was similar in both treatment groups: RR 0.96 (95%CI 0.81-1.13).
Conclusion
ARNI use in patients with heart failure is associated with a lower risk of kidney function decline and a similar risk of hyperkalemia compared to ACEIs or ARBs.
Fig 1. PRISMA Flow Diagram
Fig 2. Forest plots