{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:27:36Z","timestamp":1787160456110,"version":"build-2736575974"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":2533,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,2,11]],"date-time":"2019-02-11T00:00:00Z","timestamp":1549843200000},"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":[[2019,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess differences in diuretic dose requirements in patients treated with sacubitril\/valsartan compared with enalapril in the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure (PARADIGM-HF) trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Overall, 8399 patients with New York Heart Association class II\u2013IV heart failure and reduced LVEF were randomized to sacubitril\/valsartan 200\u2009mg bid or enalapril 10\u2009mg twice daily. Loop diuretic doses were assessed at baseline, 6, 12, and 24\u2009months, and furosemide dose equivalents were calculated via multiplication factors (2x for torsemide and 40x for bumetanide). Percentages of participants with reductions or increases in loop diuretic dose were determined. At baseline, 80.8% of participants were taking any diuretics (n\u2009=\u20096290 for loop diuretics, n\u2009=\u2009496 for other diuretics); of those, recorded dosage data for loop diuretics were available on 5487 participants. Mean baseline furosemide equivalent doses were 48.2\u2009mg for sacubitril\/valsartan and 49.6\u2009mg for enalapril (P\u2009=\u20090.25). Patients treated with sacubitril\/valsartan were more likely to reduce diuretic dose and less likely to increase diuretic dose relative to those randomized to enalapril at 6, 12, 24\u2009months post-randomization, with an overall decreased diuretic use of 2.0% (P\u2009=\u20090.02), 4.1% (P\u2009&amp;lt;\u20090.001), and 6.1% (P\u2009&amp;lt;\u20090.001) at 6, 12, and 24\u2009months, respectively, with similar findings in an on-treatment analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Treatment with sacubitril\/valsartan was associated with more loop diuretic dose reductions and fewer dose increases compared with enalapril, suggesting that treatment with sacubitril\/valsartan may reduce the requirement for loop diuretics relative to enalapril in patients with heart failure with reduced ejection fraction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.1402","type":"journal-article","created":{"date-parts":[[2019,2,11]],"date-time":"2019-02-11T06:38:27Z","timestamp":1549867107000},"page":"337-341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":156,"title":["Reduced Loop Diuretic Use in Patients Taking Sacubitril\/Valsartan Compared with Enalapril: The PARADIGM-HF Trial"],"prefix":"10.1093","volume":"21","author":[{"given":"Orly","family":"Vardeny","sequence":"first","affiliation":[{"name":"Center for Care Delivery and Outcomes Research, VA Health Care System , Minneapolis, MN ,","place":["USA"]},{"name":"Department of Medicine, University of Minnesota , Minneapolis, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Claggett","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard University , Boston, MA 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