MME and hydrops fetalis: A meta-analysis using data from three HFrEF trials that compared combined neprilysin/RAAS inhibition with RAAS inhibition alone (IMPRESS [omapatrilat vs. lisinopril], OVERTURE [omapatrilat vs. enalapril], and PARADIGM-HF [sacubitril/valsartan vs. enalapril]) showed that combined neprilysin/RAAS inhibition was associated with a reduced incidence of renal dysfunction or elevation in serum creatinine, and less pronounced decline of glomerular filtration rate (GFR) (79).