{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:01:55Z","timestamp":1792123315054,"version":"4.4.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T00:00:00Z","timestamp":1575849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T00:00:00Z","timestamp":1575849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Sacubitril\/valsartan has shown efficacy and tolerability in patients with heart failure (HF) and reduced ejection fraction (HFrEF) in the ambulatory setting (PARADIGM-HF), and following stabilisation of acutely decompensated HF (ADHF) (PIONEER-HF and TRANSITION). However, data are lacking for the initiation of sacubitril\/valsartan in newly diagnosed (de novo) HFrEF. Here, we assess the tolerability of initiating sacubitril\/valsartan following ADHF in TRANSITION subgroups of patients with a de novo vs. prior diagnosis of HFrEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>TRANSITION randomised 1002 patients to pre- and post-discharge initiation of sacubitril\/valsartan (analysis set\u2009n = 991, following exclusions for mis-randomisation). In this post-hoc analysis, tolerability to sacubitril\/valsartan [proportion of patients achieving target dose (97\/103\u2009mg b.i.d.) at 10\u2009weeks post-randomisation], adverse events (AEs) and serious AEs (SAEs) were compared in de novo (n = 286) and prior HFrEF (n = 705) subgroups. More de novo than prior HFrEF patients achieved target dose at Week 10 (56% vs. 45%; relative risk ratio 1.30, 95% confidence interval 1.12\u20131.52, P\u2009&amp;lt;\u20090.001), and fewer had SAEs and permanent treatment discontinuations. Initiation of sacubitril\/valsartan did not prevent the concomitant initiation and up-titration of guideline-directed HF therapies. De novo patients showed faster and greater decreases in N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin-T, and lower rates of HF and all-cause rehospitalisation vs. prior HFrEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After ADHF, first-line initiation of sacubitril\/valsartan in de novo HFrEF, alongside the initiation of other guideline-directed therapies, is feasible and is associated with a better risk\u2013benefit profile than in patients with prior HFrEF. Early intervention with sacubitril\/valsartan may be considered to delay disease progression in patients with de novo HFrEF.<\/jats:p>\n                    <jats:p>Clinical Trial Registration: ClinicalTrials.gov, NCT02661217.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.1670","type":"journal-article","created":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T23:49:19Z","timestamp":1575935359000},"page":"303-312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Initiation of Sacubitril\/Valsartan Shortly After Hospitalisation for Acutely Decompensated Heart Failure in Patients with Newly Diagnosed (\n                    <i>de novo<\/i>\n                    ) Heart Failure: A Subgroup Analysis of the TRANSITION Study"],"prefix":"10.1093","volume":"22","author":[{"given":"Michele","family":"Senni","sequence":"first","affiliation":[{"name":"Cardiology Division, Cardiovascular Department, Papa Giovanni XXIII Hospital , Bergamo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Wachter","sequence":"additional","affiliation":[{"name":"Clinic and Policlinic for Cardiology, University Hospital Leipzig , Leipzig ,","place":["Germany"]},{"name":"Clinic for Cardiology and Pneumology, University Medicine G\u00f6ttingen, Germany and German Cardiovascular Research Center, partner site G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus K.","family":"Witte","sequence":"additional","affiliation":[{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds , Leeds ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Straburzynska-Migaj","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, University of Medical Sciences , Poznan ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Belohlavek","sequence":"additional","affiliation":[{"name":"General Teaching Hospital, Charles University in Prague , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candida","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Internal Medicine Department, Hospital de S\u00e3o Francisco Xavier, CHLO, NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, Universidade Nova de Lisboa , Lisbon ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Mueller","sequence":"additional","affiliation":[{"name":"University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Lonn","sequence":"additional","affiliation":[{"name":"McMaster University and Hamilton Health Sciences , Hamilton, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arhit","family":"Chakrabarti","sequence":"additional","affiliation":[{"name":"Novartis Pharmaceuticals , Hyderabad ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weibin","family":"Bao","sequence":"additional","affiliation":[{"name":"Novartis Pharmaceuticals Corporation , East Hanover, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Noe","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Schwende","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmytro","family":"Butylin","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domingo","family":"Pascual-Figal","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario Virgen de la Arrixaca, Universidad de Murcia , Murcia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,12,9]]},"reference":[{"key":"2026011721335333600_ejhf1670-bib-0001","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":"2026011721335333600_ejhf1670-bib-0002","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and 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