LCZ696 (mixture of valsartan and sacubitril) was superior to enalapril in reducing the risks of death and of hospitalization for heart failure, a randomized double-blind trial showed. A total of 8442 patients with class II, III, or IV heart failure and an ejection fraction of 40% or less were assigned to receive either LCZ696 (at a dose of 200 mg twice daily) or enalapril (at a dose of 10 mg twice daily), in addition to recommended therapy. In previous studies, enalapril improved survival in patients who had heart failure with a reduced ejection fraction. As noted by the authors that the magnitude of the beneficial effect of LCZ696, as compared with enalapril, on cardiovascular mortality was at least as large as that of long-term treatment with enalapril, as compared with placebo. The LCZ696 group had higher proportions of patients with hypotension and nonserious angioedema but lower proportions with renal impairment, hyperkalemia, and cough than the enalapril group. LCZ696 prevents the clinical progression of surviving patients with heart failure more effectively than enalapril as well. Source: http://www.nejm.org/, http://circ.ahajournals.org/一项随机双盲试验表明，LCZ696（缬沙坦和sacubitril的混合物）优于依那普利降低因心衰住院和死亡的风险。共有8442例射血分数40％以下的Ⅱ，Ⅲ或Ⅳ级心衰患者分别接受LCZ696（200毫克，每日两次）或依那普利（10毫克，每日两次），加上其它推荐疗法。在以前的研究中，依那普利提高了射血分数下降心衰患者的生存率。作者指出，与依那普利相比，LCZ696降低心血管死亡率的幅度与依那普利长期治疗中，与安慰剂相比的降低幅度至少一样大。LCZ696组低血压和非严重性血管神经性水肿患者的比例较高，而肾功能不全，高钾血症和咳嗽患者的比例较依那普利组低。LCZ696也比依那普利更有效地防止幸存的心衰患者的临床症状恶化。来源：http://www.nejm.org/, http://circ.ahajournals.org/
