Characteristics of Heart Failure Patients with Reduced Left Ventricular Ejection Fraction (HFrEF) Using Angiotensin Receptor-Neprilysin Inhibitors (ARNI) Compared to Angiotensin Converting Enzyme-Inhibitor (ACE-I)/Angiotensin Receptor Blocker (ARB) Therap
Abstract
Background
Heart failure with reduced ejection fraction (HFrEF) remains a major cause of cardiovascular morbidity. While guideline-directed medical therapy, including Angiotensin Receptor Neprylisin Inhibitor (ARNI) dan Angiotensin Converting Enzyme-Inhibitor (ACE-I)/Angiotensin Receptor Blocker (ARB), is well-established, real-world clinical profiling of these patients in Indonesia remains limited.
Objectives
To evaluate and compare the baseline clinical, demographic, and pharmacological characteristics of HFrEF patients receiving ARNI versus ACE/ARB therapies at Haji Adam Malik Hospital, Medan.
Methods
This cross-sectional, descriptive study was conducted at the integrated heart center polyclinic from August to December 2025. We consecutively enrolled 50 eligible HFrEF outpatients, consisting of 25 patients receiving ACE/ARB and 25 patients receiving ARNI therapies. Data regarding demographics, medical history, and medication records were extracted and analyzed.
Results
The cohort had an overall mean age of 57.6 years and was predominantly male (78%). The primary underlying etiology was Ischemic Cardiomyopathy (86%). Key comorbidities included hypertension (54%) and diabetes mellitus (32%). Overall analysis demonstrated that demographic and clinical parameters, including age, systolic blood pressure, and comorbidities, were not significantly different between patients receiving ACE/ARB and those receiving ARNI (all p > 0.05).
Conclusion
HFrEF patients in our center are predominantly male with an ischemic etiology and a significant burden of cardiometabolic comorbidities. Baseline clinical profiles are highly comparable between those prescribed ARNI and ACE/ARB therapies, providing valuable real-world data for the optimization of HFrEF management.