In comparison with the enalapril group , fewer LCZ696-treated patients required intensification of medical treatment for heart failure ( 520 versus 604 ; hazard ratio , 0.84 ; 95 % confidence interval , 0.74-0 .94 ; P = 0.003 ) or an emergency department visit for worsening heart failure ( hazard ratio , 0.66 ; 95 % confidence interval , 0.52-0 .85 ; P = 0.001 ) .