OBJECTIVE: To systematically review the comparison of efficacy between sacubitril valsartan and renin-angiotensin-aldosterone system（RAAS） blockers in the treatment of heart failure complicated with renal insufficiency. METHODS: Randomized controlled trials of sakubatril valsartan（research group） versus RASS blockers（control group） in the treatment of heart failure complicated with renal insufficiency were systematically retrieved from 8 electronic databases until May 28

2021

the quality of included literature were assessed by using the risk of bias measure tool recommended by the Cochrane Handbook

and Meta-analysis was conducted by using RevMan 5.3 software. RESULTS: A total of 8 randomized controlled trials（including 3 575 patients） were involved. Results of the analysis showed that patients in the research group had significantly better effective rate of heart failure than that of the control group（RR=1.16

95%CI=1.07-1.26

P=0.000 2）

the research group had more significantly improved glomerular filtration rate（MD=3.09

95%CI=1.46-4.73

P=0.000 2）

amino-terminal pro-brain natriuretic peptide（MD=-309.93

95%CI=-556.77--63.10

P=0.01）

left ventricular ejection fraction（MD=4.51

95%CI=3.69-5.34

P<0.000 01）

left ventricular end-systolic diameter（MD=-4.75

95%CI=-5.63--3.86

P<0.000 01） and left ventricular end-diastolic diameter（MD=-5.02

95%CI=-6.32--3.72

P<0.000 01） than those of the control group

with statistically significant differences. CONCLUSIONS: The cardiorenal protective effect of sakubatril valsartan in patients with heart failure complicated with renal insufficiency may be superior to that of RAAS blockers.