LAUSR

Key Points Question What is the optimal drug combination for treatment of heart failure (HF) with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF)? Findings In this network meta-analysis, 19 randomized clinical trials enrolling 20 633 patients with HFpEF or HFmrEF were included. Compared with placebo, no included drug classes were associated with a reduced risk of death, but sodium-glucose cotransporter 2 (SGLT2) inhibitors, angiotensin receptor-neprilysin inhibitors, and mineralocorticoid receptor antagonists were associated with a significant decrease in hospital admission for HF; SGLT2 inhibitors were the optimal drug class for decreasing the risk of admission for HF. Meaning The results of this study suggest that the incremental use of combinations of SGLT2 inhibitors, angiotensin-converting enzyme inhibitors–angiotensin receptor blockers, and β-blockers was associated with accumulative benefits in HF hospitalization rather than all-cause death among patients with HFpEF and HFmrEF.