Evidence map›Paper›PMID 37933369›Full record

ReviewCureus2023

The Efficacy of Angiotensin Receptor-Neprilysin Inhibitor Versus Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Post Myocardial Infarction: A Meta-Analysis.

Sohny Kotak, Warda Hassan, Marium Mehmood, Umesh Kumar, Fnu Sagreeka, Fnu Karishma, Pirya Kumari, Fnu Pirya, Javeria Saquib, Amna Iqbal and 4 more

Open access · diamondAbstract readReview
In one paragraph

Review in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.5field-weighted citation impact, top 15% 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

7 citing papers in PubMed, 7 citations in OpenAlex.

  1. Observational
  2. Article
  3. Review
  4. Review
  5. Review
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  7. Review
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

14 authors at 5 institutions in 4 countries.

Sohny KotakInternal Medicine, Dow University of Health Sciences, Karachi, PAK.
Warda HassanInternal Medicine, Dow University of Health Sciences, Karachi, PAK.
Marium MehmoodInternal Medicine, Dow University of Health Sciences, Karachi, PAK.
Umesh KumarMedicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK.
Fnu SagreekaMedicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK.
Fnu KarishmaInternal Medicine, Ghulam Muhammad Mahar Medical College, Khairpur, PAK.
Pirya KumariMedicine, Peoples University of Medical and Health Sciences, Nawabshah, PAK.
Fnu PiryaMedicine, Peoples University of Medical and Health Sciences, Nawabshah, PAK.
Javeria SaquibInternal Medicine, Dow University of Health Sciences, Karachi, PAK.
Amna IqbalMedicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK.
Anosh Aslam KhanInternal Medicine, Dow University of Health Sciences, Karachi, PAK.
Giustino VarrassiPain Medicine, Paolo Procacci Foundation, Rome, ITA.
Mahima KhatriMedicine and Surgery, Dow University of Health Sciences, Karachi, PAK.
Satesh KumarMedicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK.
National University of Medical Sciences · PKShaheed Mohtarma Benazir Bhutto Medical University · PKDow University of Health Sciences · PKSree Gokulam Medical College and Research Foundation · INCivil Hospital Karachi · PK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Acute myocardial infarction (MI) is one of the leading global healthcare emergencies, contributing to over three million global deaths. The purpose of this study is to investigate further the efficacy of sacubitril/valsartan over angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in reducing the risk of heart failure (HF) in post-MI patients and providing a clear evidence-based medicine guideline for future use. An electronic database search was conducted on English databases. Eight articles were included, fulfilling our inclusion criteria, i.e., adult patients of ≥18 years with a recent diagnosis of acute MI. Pooled analysis was done using Review Manager version 5.4.1 (Cochrane Collaboration, London, England), and the data for each outcome were analyzed as dichotomous variables. A total of eight clinical trials were included in the meta-analysis. Six studies analyzed the sacubitril/valsartan and ACEI combination. The pooled analysis reported a significant increase in the risk of hypotension (relative risk {RR}: 1.29 {1.18, 1.41}) in the sacubitril/valsartan compared to the ACEI alone group. In addition, a significant increase was observed in the left ventricle ejection fraction (LVEF) after using the sacubitril/valsartan combination compared to using ACEI alone (RR: 3.08 {2.68, 4.48}). Furthermore, no significant difference was observed between the groups in terms of mortality rate (RR: 0.86 {0.73, 1.02}), the risk of heart failure (RR: 0.62 {0.39, 1.00}), the frequency of recurrent MI (RR: 0.86 {0.27, 2.76}), and the mean difference of N-terminal pro-B-type natriuretic peptide (NT-proBNP) (weighted mean difference {WMD}: -174.36 {-414.18, 65.46}) between both the groups. However, the sacubitril/valsartan combination proved to be beneficial in significantly reducing the risk of major adverse cardiac events (MACE) (RR: 0.64 {0.48, 0.84}) and rehospitalizations (RR: 0.53 {0.39, 0.71}) as compared to ACEI post MI. Additionally, sacubitril/valsartan and ARB's combination was reported in two studies. This led to a significant decrease in NT-proBNP concentration (WMD: -71.91 {-138.43, -5.39}) post MI in the sacubitril/valsartan combination group compared to the ARB usage alone. However, no significant difference was observed in the improvement of LVEF (WMD: 0.88 {-5.11, 6.87}) between both groups. Although the sacubitril/valsartan combination has no difference in mortality and outcomes compared to ACEI, there is evidence that using it proves to be more beneficial post MI compared to ACEI and ARB usage alone.

Indexed as

angiotensin-converting enzyme inhibitorsmeta-analysismimyocardial infarctionneprilysin inhibitor

Identifiers

PMID37933369
PMCPMC10625497
OpenAlexW4387380881

What Socratic holds

Textmetadata
LicenceCC BY
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 Socratic graph.