{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:40:03Z","timestamp":1777419603041,"version":"3.51.4"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1694,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008272","name":"Novartis Pharmaceuticals Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008272","name":"Novartis Pharmaceuticals Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Improving the health status (symptoms, function, and quality of life) of patients with heart failure with reduced ejection fraction (HFrEF) is a primary treatment goal. Angiotensin receptor neprilysin inhibitors (ARNI) improve short-term health status in clinical practice, but the sustainability of these improvements is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In CHAMP-HF, a multicentre observational study of outpatients with HFrEF, patients initiated on ARNI were propensity score matched 1:2 to patients not using ARNI with Cox regression modelling time to ARNI initiation, adjusted for sociodemographic and clinical variables, medical history, medications, and baseline Kansas City Cardiomyopathy Questionnaire (KCCQ) scores. Repeated measures models for the overall KCCQ score and each domain compared the health status trajectories of patients initiated on ARNI vs. not. Among 3930 participants, 746 (19.0%) began ARNI, of whom 576 were matched to 1152 non-ARNI patients. Prior to matching, participants initiated on ARNI were younger, non-Hispanic, had lower EFs, more commonly had a history of ventricular arrhythmia, were less likely to be taking an ACEI\/ARB, and more likely to be treated with beta-blockers and mineralocorticoid receptor antagonists. There were no differences after matching. In the matched cohort, participants initiated on ARNI experienced improved health status by 3 months that persisted through 12 months [KCCQ Overall Summary Score (OSS) = 73.4 vs. 70.8; P &amp;lt; 0.001], with the largest benefit observed in the KCCQ Quality of Life domain (68.7 vs. 64.7; P &amp;lt; 0.001). Similar health status benefits were noted through 18 months (KCCQ-OSS = 73.9 vs. 71.3; P &amp;lt; 0.001). A responder analysis showed that 12 patients would need to be initiated on ARNI for one to experience at least a large improvement (\u226510 points) in health status benefit at 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In outpatient practice, ARNI therapy was associated with improved health status by 3 months and continued to 18 months after initiating therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13298","type":"journal-article","created":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T05:10:04Z","timestamp":1619845804000},"page":"2670-2678","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association Between Sacubitril\/Valsartan Initiation and Real-World Health Status Trajectories Over 18 Months in Heart Failure with Reduced Ejection Fraction"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3418-6424","authenticated-orcid":false,"given":"Merrill","family":"Thomas","sequence":"first","affiliation":[{"name":"Saint Luke's Mid America Heart Institute\/University of Missouri-Kansas City , 4401 Wornall Road, Kansas City, MO, 64111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yevgeniy","family":"Khariton","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute\/University of Missouri-Kansas City , 4401 Wornall Road, Kansas City, MO, 64111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center , Los Angeles, CA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne V.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute\/University of Missouri-Kansas City , 4401 Wornall Road, Kansas City, MO, 64111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Hill","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael E.","family":"Nassif","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute\/University of Missouri-Kansas City , 4401 Wornall Road, Kansas City, MO, 64111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul S.","family":"Chan","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute\/University of Missouri-Kansas City , 4401 Wornall Road, Kansas City, MO, 64111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"University of Mississippi , Jackson, MS ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laine","family":"Thomas","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam D.","family":"DeVore","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]},{"name":"Division of Cardiology, Department of Medicine, and the Duke Clinical Research Institute, Duke University School of Medicine , Durham, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian F.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]},{"name":"Division of Cardiology, Department of Medicine, and the Duke Clinical Research Institute, Duke University School of Medicine , Durham, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy M.","family":"Albert","sequence":"additional","affiliation":[{"name":"Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Herbert","family":"Patterson","sequence":"additional","affiliation":[{"name":"Eshelman School of Pharmacy, University of North Carolina , Chapel Hill, NC ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredonia B.","family":"Williams","sequence":"additional","affiliation":[{"name":"Mended Hearts , Huntsville, AL ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute\/University of Missouri-Kansas City , 4401 Wornall Road, Kansas City, MO, 64111 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,5,1]]},"reference":[{"key":"2026012114210229000_ehf213298-bib-0001","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1161\/CIR.0b013e31829e8807","article-title":"ACCF\/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on practice guidelines","volume":"128","author":"Yancy","year":"2013","journal-title":"Circulation"},{"key":"2026012114210229000_ehf213298-bib-0002","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1161\/CIRCULATIONAHA.108.820472","article-title":"Patient health status and costs in heart failure: insights from the eplerenone post-acute myocardial infarction heart failure efficacy and survival study (EPHESUS)","volume":"119","author":"Chan","year":"2009","journal-title":"Circulation"},{"key":"2026012114210229000_ehf213298-bib-0003","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1001\/jamacardio.2017.3983","article-title":"Association of serial Kansas City Cardiomyopathy Questionnaire assessments with death and hospitalization in patients with heart failure with preserved and reduced ejection fraction: a secondary analysis of 2 randomized clinical trials","volume":"2","author":"Pokharel","year":"2017","journal-title":"JAMA Cardiol"},{"key":"2026012114210229000_ehf213298-bib-0004","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/j.jacc.2005.11.021","article-title":"Health status identifies heart failure outpatients at risk for hospitalization or death","volume":"47","author":"Heidenreich","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"2026012114210229000_ehf213298-bib-0005","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1161\/01.CIR.0000136991.85540.A9","article-title":"Prognostic value of health status in patients with heart failure after acute myocardial infarction","volume":"110","author":"Soto","year":"2004","journal-title":"Circulation"},{"key":"2026012114210229000_ehf213298-bib-0006","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1056\/NEJMoa1409077","article-title":"Angiotensin-neprilysin inhibition versus enalapril in heart failure","volume":"371","author":"McMurray","year":"2014","journal-title":"N Engl J Med"},{"key":"2026012114210229000_ehf213298-bib-0007","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1161\/CIRCULATIONAHA.107.703579","article-title":"Beyond the randomized clinical trial: the role of effectiveness studies in evaluating cardiovascular therapies","volume":"118","author":"Nallamothu","year":"2008","journal-title":"Circulation"},{"key":"2026012114210229000_ehf213298-bib-0008","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1161\/CIRCULATIONAHA.119.045178","article-title":"The challenges of observational comparative effectiveness research","volume":"141","author":"de Lemos","year":"2020","journal-title":"Circulation"},{"key":"2026012114210229000_ehf213298-bib-0009","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.jchf.2019.05.016","article-title":"Association between sacubitril\/valsartan initiation and health status outcomes in heart failure with reduced ejection fraction","volume":"7","author":"Khariton","year":"2019","journal-title":"JACC Heart Fail"},{"key":"2026012114210229000_ehf213298-bib-0010","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ahj.2017.04.010","article-title":"Change the management of patients with heart failure: rationale and design of the CHAMP-HF registry","volume":"189","author":"DeVore","year":"2017","journal-title":"Am Heart J"},{"key":"2026012114210229000_ehf213298-bib-0011","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1161\/CIRCOUTCOMES.115.001958","article-title":"Development and validation of a short version of the Kansas City Cardiomyopathy Questionnaire","volume":"8","author":"Spertus","year":"2015","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2026012114210229000_ehf213298-bib-0012","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/j.ahj.2004.12.010","article-title":"Monitoring clinical changes in patients with heart failure: a comparison of methods","volume":"150","author":"Spertus","year":"2005","journal-title":"Am Heart J"},{"key":"2026012114210229000_ehf213298-bib-0013","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1007\/s11136-016-1267-9","article-title":"Quantifying clinical change: discrepancies between patients' and providers' perspectives","volume":"25","author":"Dreyer","year":"2016","journal-title":"Qual Life Res"},{"key":"2026012114210229000_ehf213298-bib-0014","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.116.003430","article-title":"Health-related quality of life outcomes in PARADIGM-HF","volume":"10","author":"Lewis","year":"2017","journal-title":"Circ Heart Fail"},{"key":"2026012114210229000_ehf213298-bib-0015","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1001\/jamacardio.2018.0398","article-title":"Effects of sacubitril\/valsartan on physical and social activity limitations in patients with heart failure: a secondary analysis of the PARADIGM-HF trial","volume":"3","author":"Chandra","year":"2018","journal-title":"JAMA Cardiol"},{"key":"2026012114210229000_ehf213298-bib-0016","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1001\/jamainternmed.2015.0315","article-title":"Primary results of the Patient-Centered Disease Management (PCDM) for heart failure study: a randomized clinical trial","volume":"175","author":"Bekelman","year":"2015","journal-title":"JAMA Intern Med"},{"key":"2026012114210229000_ehf213298-bib-0017","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.jchf.2015.04.003","article-title":"Are hospitalizations for heart failure the great equalizer?","volume":"3","author":"Lewis","year":"2015","journal-title":"JACC Heart Fail"},{"key":"2026012114210229000_ehf213298-bib-0018","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1093\/eurjhf\/hft071","article-title":"Preferences of heart failure patients in daily clinical practice: quality of life or longevity?","volume":"15","author":"Kraai","year":"2013","journal-title":"Eur J Heart Fail"},{"key":"2026012114210229000_ehf213298-bib-0019","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/S1053-2498(01)00298-4","article-title":"Preferences for quality of life or survival expressed by patients with heart failure","volume":"20","author":"Lewis","year":"2001","journal-title":"Heart Lung Transplant"},{"key":"2026012114210229000_ehf213298-bib-0020","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1161\/CIRCULATIONAHA.119.044138","article-title":"Effects of dapagliflozin on symptoms, function, and quality of life in patients with heart failure and reduced ejection fraction: results from the DAPA-HF trial","volume":"141","author":"Kosiborod","year":"2020","journal-title":"Circulation"},{"key":"2026012114210229000_ehf213298-bib-0021","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1002\/ehf2.12981","article-title":"Heterogeneity of health status treatment response with sacubitril\/valsartan: insights from the CHAMP-HF registry","volume":"8","author":"Khariton","year":"2021","journal-title":"ESC Heart Failure"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13298","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13298","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/4\/2670\/65569123\/eschf_8_4_2670.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/4\/2670\/65569123\/eschf_8_4_2670.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:25:36Z","timestamp":1769023536000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/8\/4\/2670\/8344368"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,1]]},"references-count":21,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,5,1]]},"published-print":{"date-parts":[[2021,8,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13298","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,8]]},"published":{"date-parts":[[2021,5,1]]},"assertion":[{"value":"2021-01-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}