In PARADISE-MI (Prospective ARNI versus ACE Inhibitor Trial to Determine Superiority in Reducing Heart Failure Events after MI), valsartan-sacubitril did not lower the rate of death from cardiovascular causes or incident of HF compared with ramipril.12 There was also no reduction in the secondary end point of the risk of composite of hospitalization for HF or outpatient HF visits (HR, 0.84 [95% CI, 0.70, 1.02]). The gene discussed is ACE; the disease is hydrops fetalis.