2021 PARADISE-MI M Angiotensin Receptor-Neprilysin Inhibition in Acute Myocardial Infarction international, multicenter, randomized, double-blind, active-comparator trial S S 1. Objective: To compare the effects of sacubitril-valsartan and angiotensin converting-enzyme inhibitor, ramipril in patients with acute myocardial infarction 5661 Inclusion criteria: Adults without history of heart failure but spontaneous myocardial infarction with a reduced left ventricular ejection fraction, pulmonary congestion, or both conditions and had 21 of 8 prespecified risk-augmenting factors patients Sacubitril-valsartan group (n=2830) Ramipril group (n=2831) PRIMARY OUTCOME 11.9 Death from any causes % HR 0.88; 95% CI, 0.73 to 1.04; P=1.05 13.2 SECONDARY OUTCOME 7.5 Death from cardiovascular causes or hospitalization for heart failure % HR 0.91; 95% CI, 0.78 to 1.07 8.5 5.9 Death from cardiovascular causes % HR 0.87; 95% CI, 0.71 to 1.08 6.7 12.6 Adverse events % 13.4 Conclusion: Sacubitril-valsartan was not associated with a significantly lower incidence of death from cardiovascular causes or incident heart failure than ramipril among patients with acute myocardial infarction. MA Pfeffer et al. NEJM 2021; 385:1845-1855 Summary by Dr.Shreyash Bhoyar, MBBS M Visualmed