email article For heart attack survivors with left ventricular dysfunction, sacubitril/valsartan (Entresto) was no better than ramipril at reducing heart failure (HF) events in the strictest sense in the PARADISE-MI trial, but several signals nevertheless pointed to potential benefit in some patients. Acute MI patients shared similar rates of the primary outcome -- cardiovascular death, HF hospitalization, or outpatient development of HF over a median 23 months -- whether they had been randomized to sacubitril/valsartan or the angiotensin-converting enzyme (ACE) inhibitor (11.9% vs 13.2%, HR 0.90, 95% CI 0.78-1.04), according to Marc Pfeffer, MD, PhD, of Brigham and Women's Hospital and Harvard Medical School in Boston.