{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:41:25Z","timestamp":1777419685185,"version":"3.51.4"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":2264,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,11,8]],"date-time":"2019-11-08T00:00:00Z","timestamp":1573171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Sacubitril\/valsartan is safe when initiated during hospitalization in a clinical trial setting. Its safety in real-life population is not stablished. We compared the initiation of sacubitril\/valsartan during hospitalization in a non-selected population, in the PIONEER-HF trial, and in non-selected outpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Multicentre registry included 527 patients: 100 were started on sacubitril\/valsartan during hospitalization (19.0%) and 427 as outpatients (81.0%). Compared with those in the pivotal trial, inpatients in our cohort were older (71 \u00b1 12 vs. 61 \u00b1 14 years; P &amp;lt; 0.001); had more frequently Functional Class II (41 [41.0%] vs. 100 [22.7%]; P &amp;lt; 0.001), higher levels of N-terminal pro-B type natriuretic peptide (4044 [1630\u20138680] vs. 2013 [1002\u20134132] pg\/mL; P &amp;lt; 0.001), better glomerular filtration rate (63.5 [51.0\u201380.0] vs. 58.4 [47.5\u201371.5] mL\/min; P = 0.01), and higher systolic blood pressure (121 [110\u2013136] vs. 118 [110\u2013133] mmHg; P = 0.03); and received angiotensin-converting enzyme inhibitors\/angiotensin receptor blockers more frequently (92 [92.0%] vs. 208 [52.7%]; P &amp;lt; 0.001). Compared with non-selected outpatients, inpatients were older (71 \u00b1 12 vs. 68 \u00b1 12 years, P = 0.02), had more frequent Functional Class III\u2013IV (58 [58.0%] vs. 129 [30.3%], P &amp;lt; 0.001), had higher levels of N-terminal pro-B type natriuretic peptide (4044 [1630\u20138680] vs. 2182 [1134\u20134172]; P &amp;lt; 0.001), and were receiving angiotensin-converting enzyme inhibitors\/angiotensin receptor blockers target dose less frequently (55 [55.0%] vs. 335 [78.5%]; P &amp;lt; 0.001). They also started sacubitril\/valsartan with a low dose (50 mg\/12 h) more frequently (80 [80.0%] vs. 209 [48.8%], P &amp;lt; 0.001). The initiation of sacubitril\/valsartan in outpatients was an independent predictor of high-dose use (OR 3.1; 95% confidence interval 1.7\u20135.6, P &amp;lt; 0.001). The follow-up time in both cohorts, including all patients enrolled, was similar (7.0 \u00b1 0.1 vs. 7.2 \u00b1 2.6 months, P = 0.72). All-cause admissions during follow-up were more frequent in inpatients (30 [30.0%] vs. 68 outpatients [15.9%], P = 0.001), with no relevant differences in all-cause mortality. There was no significant difference in sacubitril\/valsartan withdrawal rate (17 inpatients [17.0%] vs. 49 outpatients [11.5%], P = 0.13). The incidence of adverse effects was also similar: hypotension (16 inpatients [16.0%] vs. 71 outpatients [16.7%], P = 0.88), worsening renal function (7 inpatients [7.0%] vs. 29 outpatients [6.8%], P = 0.94), and hyperkalaemia (1 inpatient [1.0%] vs. 21 outpatients [4.9%], P = 0.09). We did not register any case of angioedema.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>It is safe to initiate sacubitril\/valsartan during hospitalization in daily clinical practice. Inpatients have a higher risk profile and receive low starting doses more frequently than outpatients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12527","type":"journal-article","created":{"date-parts":[[2019,11,8]],"date-time":"2019-11-08T03:08:55Z","timestamp":1573182535000},"page":"1161-1166","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Safety of Sacubitril\/Valsartan Initiated During Hospitalization: Data from a Non-Selected Cohort"],"prefix":"10.1093","volume":"6","author":[{"given":"Juan Carlos","family":"L\u00f3pez-Azor","sequence":"first","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Gregorio Mara\u00f1\u00f3n, CIBERCV , Calle Doctor Esquerdo, 46, 28007, Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lourdes","family":"Vicent","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Gregorio Mara\u00f1\u00f3n, CIBERCV , Calle Doctor Esquerdo, 46, 28007, Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jes\u00fas","family":"Valero-Masa","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Gregorio Mara\u00f1\u00f3n, CIBERCV , Calle Doctor Esquerdo, 46, 28007, Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Esteban-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario de M\u00f3stoles , Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"G\u00f3mez-Bueno","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Puerta de Hierro, CIBERCV , Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00e1ngel","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital de Burgos , Burgos ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"D\u00edez-Villanueva","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital de La Princesa , Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"De-Juan","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario 12 de Octubre , Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00e1ngel","family":"Manuel-Iniesta","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario La Paz , Madrid ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ram\u00f3n","family":"Bover","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Hospital Universitario Cl\u00ednico de San Carlos. 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