Objective To access the clinical effectiveness of sacubitril/valsartan (LCZ696) in patients with chronic heart failure complicated with renal insufficiency.

Methods A total of 196 patients with reduced ejection fraction heart failure (HFrEF) and renal insufficiency were selected, who were treated in the Department of Cardiology, Minhang Hospital, Fudan University from September 2018 to September 2020. All patients received LCZ696 along with guideline directed medicine therapy (GDMT). The follow-up period was 9 months. The New York Heart Association (NYHA) function grading, quality of life score, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level, eGFR, and serum potassium level of patients were compared before and after treatment.

Results Compared to before treatment, LVEF increased, LVEDD reduced, NYHA classification improved, and NT-proBNP reduced in patients after treatment (P < 0.001). For the quality of life, total score and each specific domains (somatic, emotional, etc.) were significantly lower than before treatment (P < 0.05). Compared to before treatment, the daytime and nighttime systolic blood pressure values were significantly lowered (P < 0.05), while eGFR was significantly higher (P < 0.01), the level of serum potassium remained stable.

Conclusions LCZ696 along with GDMT treatment could improve heart and renal function, and quality of life of HFrEF patients with renal insufficiency, with an acceptable safety profile.