@article{103578,
  keywords = {angiotensin receptor-neprilysin inhibitor, angiotensin-converting enzyme inhibitor, Chagas Cardiomyopathy, enalapril, heart failure with reduced ejection fraction, Sacubitril/valsartan},
  author = {AlSejari N and Gadelmawla A and Alfehaid A and AlMutairi O and Taqi M and Alibrahim A and AlOmar H and AlShammari M and Alharran A and Alsubaiei A and Frishman W and Aronow W},
  title = {Sacubitril/Valsartan Versus Enalapril in Chagas Cardiomyopathy With Heart Failure: A Systematic Review and Meta-Analysis},
  abstract = {<p>Chagas cardiomyopathy represents a distinct and understudied etiology of heart failure with reduced ejection fraction (HFrEF). This meta-analysis aims to compare the efficacy and safety of sacubitril/valsartan versus enalapril in the treatment of patients with HFrEF due to Chagas cardiomyopathy with a total of 1225 patients (615 in the sacubitril/valsartan group and 610 in the enalapril group). There were no statistically significant differences between sacubitril/valsartan and enalapril in hospitalization for heart failure [risk ratios (RR) = 0.93; 95% confidence intervals (CI), 0.74-1.16; P = 0.53], cardiovascular mortality (RR = 0.91; 95% CI, 0.73-1.12; P = 0.37), or all-cause mortality (RR = 0.96; 95% CI, 0.79-1.17; P = 0.69). Heterogeneity was low across all efficacy outcomes (I2 = 0-4.1%). Similarly, we found no significant differences in safety outcomes, including symptomatic hypotension (RR = 1.14; 95% CI, 0.94-1.39), kidney dysfunction (RR = 1.08; 95% CI, 0.84-1.39), or hyperkalemia (RR = 1.26; 95% CI, 0.37-4.32). Our results indicated that sacubitril/valsartan has comparable efficacy to enalapril with no significant differences in hospitalization for heart failure, cardiovascular mortality, or all-cause mortality in patients with HFrEF secondary to Chagas cardiomyopathy.</p>},
  year = {2026},
  journal = {Cardiology in review},
  month = {04/2026},
  issn = {1538-4683},
  doi = {10.1097/CRD.0000000000001270},
  language = {ENG},
}