Reporter brief

A cross-trial aggregate-data meta-analysis combined hazard ratios from six Phase III randomised trials to estimate the effect of quintuple disease-modifying therapy (including ACE inhibitors/ARBs, beta-blockers, aldosterone antagonists, SGLT2 inhibitors, and vericiguat) versus conventional therapy in heart failure with reduced ejection fraction. The imputed combined effect showed HR 0.34 (95% CI 0.27–0.42) for cardiovascular death or first heart failure hospitalisation, HR 0.31 for first HF hospitalisation alone, HR 0.47 for cardiovascular death alone, and HR 0.51 for all-cause mortality.

Assessment pending; this report does not establish a change in evidence.

• —Limitations have not been recorded; consult the primary source.

Meta analysis; Human.

Patients with heart failure with reduced ejection fraction

Design

Meta analysis

Sample

—

Journal

Cardiac failure review

Published

Aug 17, 2026

Primary outcome: HR 0.34 (95% CI [0.27-0.42]); Cardiovascular death: HR 0.47 (95% CI [0.35-0.63]); First heart failure hospitalisation: HR 0.31 (95% CI [0.23-0.40]); All-cause mortality: HR 0.51 (95% CI [0.39-0.67]); NNT per year for primary outcome: 10, cardiovascular death: 23, first heart failure hospitalisation: 15

• —Assessment: Pending.
• —Only the source material recorded on this evidence page was assessed.

Not recorded.

See the SGLT2 inhibitors timeline and recorded assessment for prior evidence.