Efficacy of sodium–glucose cotransporter 2 inhibitors and angiotensin receptor–neprilysin inhibitors for heart failure in black patients: a systematic review and meta‐analysis of randomized controlled trials.

Efficacy of sodium-glucose cotransporter 2 inhibitors and angiotensin receptor-neprilysin inhibitors for heart failure in black patients: a systematic review and meta-analysis of randomized controlled trials Reported rate ratios for the primary outcome from one trial of an ARNI in HFpEF were 0.69 (95% CI 0.24, 1.99) in black patients compared with 0.83 (95% CI 0.71, 0.97; I p i -interaction not provided) in white patients. Black patients have a disproportionately high incidence of heart failure (HF).[1] Black patients present at an earlier age with HF and have worse outcomes compared to non-black patients.[1] Despite this, they are often underrepresented in clinical trials.[2] Targeted trials in this high-risk population such as the African American Heart Failure (A-HeFT) trial have been infrequent.[3] The disparate effects of established classes of HF therapeutics including beta-blockers, renin-angiotensin-aldosterone system (RAAS) inhibitors and mineralocorticoid receptor antagonists (MRAs) according to race have been previously described.[[4]] The efficacy of newer medical therapies in black patients with HF remains an important and unanswered question. Prior analyses have suggested that some HF therapies such as spironolactone may be less effective in black patients.[[4], [22]] Finally, our results highlight the need to increase representation of black patients in HF trials. [Extracted from the article]