{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:23:14Z","timestamp":1791310994353,"version":"4.3.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"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"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Worsening renal function may impact long\u2010term outcomes in heart failure (HF). However, little is known about the longitudinal trajectories in renal function in relation to HF hospitalization or how this high\u2010risk clinical event impacts renal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      In PARAGON\u2010HF, we evaluated the association between recency of prior HF hospitalization (occurring pre\u2010randomization) and subsequent first renal composite outcome: (i) time to \u226550% decline in estimated glomerular filtration rate (eGFR); (ii) development of end\u2010stage renal disease; or (iii) death attributable to renal causes. A total of 2306 (48.1%) patients had a history of prior HF hospitalization. Incident rates of the renal outcome were highest in those most recently hospitalized and decreased with longer time from last hospitalization. Treatment effect on the renal outcome of sacubitril\/valsartan versus valsartan was similar between patients with (hazard ratio [HR] 0.43; 95% confidence interval [CI] 0.24\u20130.76) and without (HR 0.63; 95% CI: 0.33\u20131.18;\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u00a0=\u00a00.39) a prior history of HF hospitalization and appeared consistent regardless of timing of prior hospitalization for HF (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u00a0=\u00a00.39). Serial eGFR measurements leading up to and after a HF hospitalization (occurring during the study period) and estimated eGFR trajectories using repeated measures regression models with restricted cubic splines were also examined. Patients experiencing a post\u2010randomization HF hospitalization had a significant decline in eGFR prior to hospitalization while patients without HF hospitalization experienced a relatively stable eGFR trajectory (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A change in the rate of decline of eGFR trajectory was observed 12\u2009months preceding a HF hospitalization, and continued in the post\u2010discharge window to 12\u2009months following hospitalization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Heart failure hospitalization denotes increased risk for kidney disease progression which continues following recovery from HF decompensation in patients with HF with preserved ejection fraction.<\/jats:p>\n                    <jats:p>\n                      Clinical Trial Registration: PARAGON\u2010HF (Prospective Comparison of ARNI with ARB Global Outcomes in HF with Preserved Ejection Fraction),\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      NCT01920711.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2638","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T14:39:31Z","timestamp":1658932771000},"page":"1906-1914","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Longitudinal trajectories in renal function before and after heart failure hospitalization among patients with heart failure with preserved ejection fraction in the\n                    <scp>PARAGON\u2010HF<\/scp>\n                    trial"],"prefix":"10.1093","volume":"24","author":[{"given":"Safia","family":"Chatur","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Peikert","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian L.","family":"Claggett","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finnian R.","family":"McCausland","sequence":"additional","affiliation":[{"name":"Renal Division, Brigham and Women's Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hicham","family":"Skali","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Pfeffer","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris E.","family":"Beldhuis","sequence":"additional","affiliation":[{"name":"University of Groningen, Department of Cardiology University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Kober","sequence":"additional","affiliation":[{"name":"Rigshospitalet Copenhagen University Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar","family":"Seferovic","sequence":"additional","affiliation":[{"name":"University of Belgrade School of Medicine Belgrade University Medical Center  Belgrade Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lefkowitz","sequence":"additional","affiliation":[{"name":"Novartis Pharmaceuticals Corporation  East Hanover NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.V.","family":"McMurray","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.696906"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.114.001567"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2015.14"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.05.002"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1697"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.047643"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.008789"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.11.003"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2017.04.013"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1908655"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.047019"},{"key":"e_1_2_5_13_1","first-page":"68","article-title":"Association of visit\u2010to\u2010visit variability in kidney function and serum electrolyte indexes with risk of adverse clinical outcomes among patients with heart failure with preserved ejection fraction","volume":"6","author":"Segar MW","year":"2021","journal-title":"JAMA Cardiol"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht386"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1313731"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107038"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.070"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2464"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2007.83"}],"container-title":["European Journal of Heart 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