{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T13:36:44Z","timestamp":1769089004803,"version":"3.49.0"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":2958,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2017,12,14]],"date-time":"2017-12-14T00:00:00Z","timestamp":1513209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008792","name":"Novartis Pharma AG","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008792","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Novartis Pharma AG"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The prognosis after hospitalization for acute decompensated heart failure (ADHF) remains poor, especially &amp;lt;30 days post-discharge. Evidence-based medications with prognostic impact administered at discharge improve survival and hospital readmission, but robust studies comparing pre-discharge with post-discharge initiation are rare. The PARADIGM-HF trial established sacubitril\/valsartan as a new evidence-based therapy in patients with heart failure (HF) and reduced left ventricular ejection fraction (&amp;lt;40%) (rEF). In common with other landmark studies, it enrolled patients who were ambulatory at the time of inclusion. In addition, there is also still limited knowledge of initiation and up-titration of sacubitril\/valsartan in ACEi\/ARB- na\u00efve patients and in de novo HF with rEF patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>TRANSITION is a multicentre, open-label study in which ~1000 adults hospitalized for ADHF with rEF are randomized to start sacubitril\/valsartan in a pre-discharge arm (initiated \u226524 h after haemodynamic stabilization) or a post-discharge arm (initiated within Days 1\u201314 after discharge). The protocol allows investigators to select the appropriate starting dose and dose adjustments according to clinical circumstances. Over a 10 week treatment period, the primary and secondary objectives assess the feasibility and safety of starting sacubitril\/valsartan in-hospital, early after haemodynamic stabilization. Exploratory objectives also include assessment of HF signs and symptoms, readmissions, N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T levels, and health resource utilization parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TRANSITION will provide new evidence about initiating sacubitril\/valsartan following hospitalization for ADHF, occurring either as de novo ADHF or as deterioration of chronic HF, and in patients with or without prior ACEI\/ARB therapy. The results of TRANSITION will thus be highly relevant to the management of patients hospitalized for ADHF with rEF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12246","type":"journal-article","created":{"date-parts":[[2017,12,14]],"date-time":"2017-12-14T08:16:37Z","timestamp":1513239397000},"page":"327-336","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Rationale and Design of TRANSITION: A Randomized Trial of Pre-Discharge vs. Post-Discharge Initiation of Sacubitril\/Valsartan"],"prefix":"10.1093","volume":"5","author":[{"given":"Domingo","family":"Pascual-Figal","sequence":"first","affiliation":[{"name":"Heart Failure and Heart Transplantation Unit, Cardiology Department, Virgen de la Arrixaca University Hospital, Universidad de Murcia , Ctra. Madrid-Cartagena s\/n, 30120, Murcia ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf","family":"Wachter","sequence":"additional","affiliation":[{"name":"Clinic and Policlinic for Cardiology, University Hospital Leipzig \u00a0","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Senni","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Department, Hospital Papa Giovanni XXIII\u2014Bergamo , Bergamo ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Belohlavek","sequence":"additional","affiliation":[{"name":"Complex Cardiovascular Centre, General Teaching Hospital, Charles University , Prague ,","place":["Czech Republic"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adele","family":"No\u00e8","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG , Basel ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Carr","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG , Basel ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dmytro","family":"Butylin","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG , Basel ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2017,12,14]]},"reference":[{"key":"2026012115120080700_ehf212246-bib-0001","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1093\/eurheartj\/ehs104","article-title":"ES Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. 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