Comparison of Effectiveness and Safety between ARNI and ACEI/ARB in HFrEF patients with moderate to severe chronic kidney disease in China
Exploring the efficacy and safety of under target dose of Sacubitril/valsartan (ARNI) (Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptor Blockers) in HFrEF (heart failure with reduced ejection fraction) patients with moderate to severe chronic kidney disease (CKD) in China,compared with ACEI/ARB group. The inverse probability of treatment weighting analysis (IPTW) was performed to compare the baseline and the clinical outcomes between the two groups.The incidence of death caused by cardiovascular disease and the rehospitalization caused by heart failure after treatments, the rate of leading to ESKD, the improvement of cardiac function (New York Heart Association) were collected after 12 months` follow up.The improvement of ejection fraction(EF), troponin N terminal of prohormone brain natriuretic peptide (NT-ProBNP), left ventricular end systolic diameter?(LVESD),left ventricular end diastolic diameter (LVEDD) were compared between baseline and follow up.The safety outcomes such as the change of potassium level and blood pressure after 12 months` follow up were also collected. Patients in the ARNI group showed lower rate of death caused by cardiovascular disease,lower incidence of rehospitalization.The New York Heart Association (NYHA)class function, the level of eGFR, EF and NT-ProBNP, LVEDD, LVESD got better improved in the ARNI group.the increased of blood potassium level and the decreased of blood pressure were similar between the two groups.