ACE and hydrops fetalis: Indeed, ARNi treatment is very efficacious in lowering the risks of death and hospitalization for HF in patients with HF and New York Heart Association (NYHA) functional class II to III symptoms, but trials have failed to demonstrate any advantages with ARNi versus ACE inhibitors or ARBs in patients with advanced HFrEF or in patients after myocardial infarction with attendant LV dysfunction but without HF [72].