Combination Medical Therapy Benefit in Heart Failure with LVEF >45%

Researchers provide estimates of risk reduction in the LVEF range for which combination ARNI, MRA, and SGLT2i is not strongly supported by guidelines.

In patients with heart failure with reduced left ventricular ejection fraction (LVEF), the evidence for the use of mineralocorticoid receptor antagonists (MRAs), the angiotensin-receptor neprilysin inhibitor (ARNI) sacubitril/valsartan, and sodium–glucose cotransporter-2 inhibitors (SGLT-2is) is firm, but for those with mildly reduced and preserved ejection fraction, it is evolving. Investigators leveraged clinical trial data on treatment effects of individual therapies to produce estimates of the effects of combination therapy with these agents in the LVEF range that is not strongly guideline supported. They assumed additive effects and did not examine variation by patient characteristics beyond the ejection fraction.

The estimated reductio…

Reviewing Author

Harlan M. Krumholz, MD, SM

Disclosures

Consultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime

EquityHugo Health; Refactor Health; Element Science

Grant/Research SupportPfizer; Agency for Healthcare Research and Quality; Janssen Research and Development, National Institute of Biomedical Imaging and Engineering; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; National Cancer Institute; American Heart Association

Harlan M. Krumholz, MD, SM

Disclosures

Consultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime

EquityHugo Health; Refactor Health; Element Science

Combination Medical Therapy Benefit in Heart Failure with LVEF >45%

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Reviewing Author