{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T15:21:10Z","timestamp":1781104870172,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T00:00:00Z","timestamp":1723680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Although the benefits of sacubitril\/valsartan in heart failure with reduced ejection fraction (HFrEF) are well established, patients with hemodynamically significant mitral regurgitation (MR) were excluded from pivotal trials. We aimed to assess the effects of sacubitril\/valsartan on survival in patients with HFrEF and concomitant significant MR. All patients from a single center who underwent echocardiography between June 2008 and December 2020, with a left ventricular ejection fraction (LVEF) of less than 40% and hemodynamically significant MR were recruited. Patients were categorized according to drug use and year of the index echocardiogram into the angiotensin receptor\/neprilysin inhibitor (ARNI), non\u2010ARNI before 2017, and non\u2010ARNI after 2017 groups. Patients in the ARNI and non\u2010ARNI after 2017 groups were compared directly, whereas patients in the non\u2010ARNI before 2017 group were matched to the ARNI group in a 3:1 ratio. The outcome of interest was all\u2010cause mortality. Death was compared between the groups using univariate and multivariate Cox proportional hazard models. After exclusion by criteria and matching, there remained 610 patients in the ARNI group, 434 in the non\u2010ARNI after 2017 group, and 1,722 in the non\u2010ARNI before 2017 group. During follow\u2010up, all\u2010cause mortality was significantly lower in the ARNI group compared with both non\u2010ARNI after 2017 and non\u2010ARNI before 2017 groups. Multivariate analysis of both pairs of comparison between groups found the use of ARNI to be significantly associated with increased survival. In patients with HFrEF and concomitant significant MR, treatment with sacubitril\/valsartan was associated with lower risks of all\u2010cause death.<\/jats:p>","DOI":"10.1002\/cpt.3417","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T06:44:15Z","timestamp":1723790655000},"page":"143-152","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Sacubitril\/Valsartan on Survival in Patients with Heart Failure and Significant Valvular Heart Disease"],"prefix":"10.1002","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5799-6513","authenticated-orcid":false,"given":"Donna Shu\u2010Han","family":"Lin","sequence":"first","affiliation":[{"name":"Division of Cardiology\u00b8Department of Internal Medicine Shin Kong Wu Ho\u2010Su Memorial Hospital  Taipei 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