{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T23:27:05Z","timestamp":1791070025638,"version":"4.1.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1601,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T00:00:00Z","timestamp":1627862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We systematically reviewed the European real-world evidence (RWE) about sacubitril-valsartan for heart failure with reduced ejection fraction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Twenty-one articles, including 16 952 subjects, were identified until 31 October 2020. Taking as reference the PARADIGM-HF cohort, few baseline characteristics were presented in &amp;gt;80% of these studies, most often with high heterogeneity. In random-effects model meta-analysis, age was higher (mean difference +3.84, 95% CI 1.92\u20135.76), ischaemic aetiology (OR 0.76, 95% CI 0.64\u20130.91), hypertension (OR 0.55, 95% CI 0.37\u20130.82), and diabetes (OR 0.77, 95% CI 0.64\u20130.92) were less common, and the use of mineralocorticoid receptor antagonists was more frequent (OR 3.54, 95% CI 2.27\u20135.53) in real-life than in PARADIGM-HF. Other clinical and medical features were presented in 19\u201376% of the selected publications and suggested more severe heart failure with reduced ejection fraction. Sacubitril-valsartan was titrated to 97\/103 mg b.i.d. in 35% (95% CI 23\u201347) and discontinued in 12.8% (95% CI 7.4\u201318.3) patients. When reported, the incidence of hyperkalaemia (six studies, no. 1076), all-cause mortality (five studies, no. 684), and any hospitalization (three studies, no. 390) was 12 (95% CI 5\u201319)\/100 person-year, 8 (95% CI 4\u201312)\/100 person-year, and 24 (95% CI 5\u201342)\/100 person-year, respectively. Knowledge contribution, a metric measuring the proportion of RWE provided by each article based on the number of reported variables and the sample size, was 58.8% and 13.6% for the two biggest investigations (12 082 and 2037 patients), and &amp;lt;5% for all others (most with &amp;lt;100 subjects).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Limited-quality RWE indicates that there are important differences between European patients prescribed sacubitril-valsartan and the PARADIGM-HF population, including the frequency of target dose achievement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13547","type":"journal-article","created":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T08:40:18Z","timestamp":1627893618000},"page":"3547-3556","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Sacubitril\/Valsartan in Real-Life European Patients with Heart Failure and Reduced Ejection Fraction: A Systematic Review and Meta-Analysis"],"prefix":"10.1093","volume":"8","author":[{"given":"Stefano","family":"Giovinazzo","sequence":"first","affiliation":[{"name":"Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, IRCCS Italian Cardiology Network , Genoa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Carmisciano","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Biostatistics, University of Genova , Genoa 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