Mann DL, Givertz MM, Vader JM, et al. - In chronic advanced heart failure with a reduced ejection fraction, treatment with sacubitril/valsartan does not afford a statistically significantly different lowering of N-terminal pro–brain natriuretic peptide (NT-proBNP) levels than valsartan.

• A randomized clinical trial of 335 patients with advanced heart failure who were randomized to sacubitril/valsartan or valsartan in addition to recommended therapy.

• Area under the curve (AUC) for the ratio of NT-proBNP compared with baseline through 24 weeks of treatment was not significantly different in 167 patients in the sacubitril/valsartan treatment arm vs 168 patients in the valsartan treatment arm (AUC was 1.08 vs 1.19, respectively).

• The clinical composite of number of days alive, out of hospital, and free from heart failure events was not improved with sacubitril/valsartan vs valsartan.

• The sacubitril/valsartan arm showed a statistically significant increase in non–life-threatening hyperkalemia, but no other safety concerns were noted.