ARNI has a higher total effective rate (RR: 1.15, 95%CI: 1.08–1.21), Kansas City cardiomyopathy questionnaire (WMD: 4.13, 95%CI: 3.46–4.81), and 6-Minute Walk Test (WMD: 51.35, 95%CI: 26.99–75.71) compared with angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB). This evidence concerns the gene ACE and cardiomyopathy.