Evidence map›Paper›PMID 39473218›Full record

SynthesisESC heart failure2025

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

Gianluca Di Pietro, Riccardo Improta, Paolo Severino, Andrea D'Amato, Lucia Ilaria Birtolo, Ovidio De Filippo, Antonio Lattanzio, Raffaele De Cristofaro, Giacchino Galardo, Fabrizio D'Ascenzo and 6 more

Abstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Early SGLT2i Therapy Facilitates In-Hospital ARNI Introduction Improving 6-Month Systolic Function in Patients with HFrEF.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026
    Observational
  4. 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

16 authors.

Gianluca Di PietroDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Riccardo ImprotaDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Paolo SeverinoDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Andrea D'AmatoDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Lucia Ilaria BirtoloDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Ovidio De FilippoDepartment of Cardiovascular and Thoracic, Division of Cardiology, Città della Salute e della Scienza Hospital, Turin, Italy.
Antonio LattanzioDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Raffaele De CristofaroDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Giacchino GalardoMedical Emergency Unit, La Sapienza University of Rome, Rome, Italy.
Fabrizio D'AscenzoDepartment of Cardiovascular and Thoracic, Division of Cardiology, Città della Salute e della Scienza Hospital, Turin, Italy.
Roberto BadagliaccaDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Gennaro SardellaDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Maurizio VolterraniIRCCS San Raffaele Pisana, Rome, Italy.
Francesco FedeleDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Carmine Dario VizzaDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.
Massimo ManconeDepartment of Internal Clinical, Anesthesiological, Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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 < 0.0001] and lower rate of repeat rehospitalization for heart failure (OR 0.40, 95% CI 0.26-0.62, P < 0.0001), compared with a standard regimen. Additionally, left ventricle volumes were significantly lower in the ARNi group [left ventricular end-diastolic volume, mean difference (MD) 11.48 mL, 95% CI 6.10-16.85, P < 0.0001; left ventricular end-systolic volume, MD 7.09 mL, 95% CI 2.89-11.29, P = 0.0009] with a significant change in left ventricular ejection fraction (MD 3.07, 95% CI 1.61-4.53, P < 0.0001), compared with standard therapy. No significant differences were observed in terms of cardiac death, all cause of mortality, non-fatal myocardial infarction and N terminal pro brain natriuretic peptide. Higher rates of iatrogenic hypotensive events were observed in the ARNi group compared with the standard therapy (OR 1.42, 95% CI 1.26-1.60, P value < 0.00001). In patients with acute myocardial infarction related heart failure, the in-hospital administration of ARNis was associated with a reduced risk of major cardiovascular events and re-hospitalization for heart failure, as well as cardiac remodelling, but higher rates of hypotensive events compared with standard therapy.

Indexed as

AminobutyratesHospitalizationMyocardial InfarctionTetrazolesValsartanAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug CombinationsGlobal HealthHeart FailureHumansRandomized Controlled Trials as TopicStroke VolumeVentricular Function, LeftAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug Combinationssacubitril and valsartan sodium hydrate drug combinationTetrazolesValsartanacute myocardial infarctionangiotensin receptor‐neprylisin Inihibitorsheart failuremedical therapysacubitrilvalsartan

Identifiers

PMID39473218
PMCPMC11911573

What Socratic holds

Textmetadata
LicenceCC BY-NC
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.