{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:44:52Z","timestamp":1783644292060,"version":"3.55.0"},"reference-count":9,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"Importance<\/jats:title>Angiotensin receptor-neprilysin inhibition (ARNI) improves mortality among patients with heart failure with reduced ejection fraction (HFrEF), ie, those with an EF of 40% or less.<\/jats:p><\/jats:sec>Objective<\/jats:title>To describe national longitudinal trends in ARNI prescribing patterns among hospitalized patients with HFrEF.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>Using data from the Get With The Guidelines\u2013Heart Failure (GWTG-HF) registry, hospitalized patients with HFrEF at 614 participating hospitals were identified. Rates of ARNI, angiotensin converting enzyme inhibitor (ACEI), and angiotensin II receptor blocker (ARB) prescription at discharge were evaluated across 3 time periods. Adjusted logistic regression and piecewise logistic regression were used to evaluate the impact of publication dates on ARNI prescription rates.<\/jats:p><\/jats:sec>Exposures<\/jats:title>ARNI prescribing patterns in hospitalized patients with HFrEF.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Rates of ARNI, ACEI, and ARB prescription at discharge were evaluated across 3 time periods as follows: (1) period 1 included the US Food and Drug Administration (FDA) approval of sacubitril-valsartan to the day before the PIONEER-HF (Comparison of Sacubitril-Valsartan vs Enalapril on Effect on N-Terminal Pro\u2013Brain Natriuretic Peptide in Patients Stabilized From an Acute Heart Failure Episode) trial publication (July 7, 2015-November 10, 2018); (2) period 2 included the day of the PIONEER-HF trial publication to the day before publication of the 2021 Update to the 2017 Consensus for Optimization of Heart Failure Treatment (November 11, 2018-January 10, 2021); and (3) period 3 included the day of the 2021 update publication to the last available data at the time of analysis (January 11, 2021-December 31, 2022).<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 114\u202f333 hospitalized patients (mean [IQR] age, 67.0 [57.0-78.0] years; 74\u202f765 male [65.4%]) were included in this study. Rates of ARNI prescribed at discharge increased from 1.1% (27 of 2451) during July 7, 2015, to September 30, 2015, to 55.4% (1957 of 3536) during October 1, 2022, to December 31, 2022. ACEI or ARB prescription at discharge fell from 88.3% (2612 of 2957) to 45.9% (2033 of 4434) over the same period, whereas ACEI, ARB, or ARNI prescription increased from 71.1% (2639 of 3713) to 84.7% (3990 of 4711). In adjusted logistic regression models, compared with period 1, patients discharged during period 2 and period 3 were found to have a 3.81-fold (95% CI, 3.65-3.98) and 9.15-fold (95% CI, 8.79-9.52) increased odds of ARNI prescription at discharge, and a 0.46 (95% CI, 0.45-0.48) and 0.25 (95% CI, 0.24-0.26) decreased odds of ACEI or ARB prescription at discharge.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>Results of this cross-sectional study reveal that in the 7 years after FDA drug approval of sacubitril-valsartan, rates of ARNI or ACEI, ARB, or ARNI prescription at discharge increased, and rates of ACEI or ARB prescription decreased. Overall prescription of ARNI at discharge was 55.4% in eligible patients at the end of the study, suggesting remaining opportunity for continued improvement in ARNI prescription.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamacardio.2024.3815","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T20:27:32Z","timestamp":1733948852000},"page":"276","source":"Crossref","is-referenced-by-count":3,"title":["Angiotensin Receptor-Neprilysin Inhibitor Prescribing Patterns in Patients Hospitalized for Heart Failure"],"prefix":"10.1001","volume":"10","author":[{"given":"Pratyaksh K.","family":"Srivastava","sequence":"first","affiliation":[{"name":"Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra M.","family":"Klomhaus","sequence":"additional","affiliation":[{"name":"Department of Medicine, Statistics Core, UCLA, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Greene","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabra C.","family":"Lewsey","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clyde W.","family":"Yancy","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center, Los Angeles, California"},{"name":"Associate Section Editor, JAMA Cardiology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"hbr240016r2","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.jchf.2016.12.018","article-title":"Early adoption of sacubitril\/valsartan for patients with heart failure with reduced ejection fraction: insights from Get With the Guidelines-Heart Failure (GWTG-HF).","volume":"5","author":"Luo","year":"2017","journal-title":"JACC Heart Fail"},{"issue":"1","key":"hbr240016r3","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1186\/s12913-021-07196-4","article-title":"Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review.","volume":"21","author":"Medlinskiene","year":"2021","journal-title":"BMC Health Serv Res"},{"issue":"10","key":"hbr240016r4","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1001\/jama.294.10.1240","article-title":"Risk-treatment mismatch in the pharmacotherapy of heart failure.","volume":"294","author":"Lee","year":"2005","journal-title":"JAMA"},{"issue":"5","key":"hbr240016r5","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1016\/j.ahj.2004.07.026","article-title":"Why do patients fail to receive beta-blockers for chronic heart failure over time? 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