{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T22:39:34Z","timestamp":1783982374601,"version":"3.55.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":404,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"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":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Whether prior treatment with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) modifies efficacy and safety of sacubitril\/valsartan (Sac\/Val) in patients with heart failure (HF) and ejection fraction (EF)\u2009&amp;gt;40% is unclear, thus Sac\/Val according to ACEi\/ARB status at baseline was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This was a pre-specified analysis of Prospective comparison of ARNI with ARB Given following stabiLization In DEcompensated HFpEF (PARAGLIDE-HF), a double-blind, randomized controlled trial of Sac\/Val versus valsartan, categorizing patients according to baseline ACEi\/ARB status. The primary endpoint was time-averaged proportional change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) from baseline through weeks 4 and 8. Secondary analyses included a win-ratio analysis of the hierarchical outcome of (i) cardiovascular death; (ii) HF hospitalizations; (iii) urgent HF visits; and (iv) time-averaged proportional change in NT-proBNP from baseline to weeks 4 and 8, in addition to safety outcomes. Among 466 patients, 107 (23%) were ACEi\/ARB na\u00efve at the time of randomization. NT-proBNP favoured Sac\/Val irrespective of ACEi\/ARB status (na\u00efve: 0.76, 95% confidence interval [CI] 0.51\u20131.13; users: 0.88, 95% CI 0.74\u20131.05; pinteraction\u2009=\u20090.52). The win ratio of the hierarchical outcome was 1.13 (95% CI 0.86\u20131.49) for ACEi\/ARB users and 1.38 (95% CI 0.81\u20132.37) for ACEi\/ARB na\u00efve (pinteraction\u2009=\u20090.51). Safety endpoints showed non-significant interactions by ACEi\/ARB status, with odds ratio of 1.79 (95% CI 0.68\u20134.72) and 0.71 (95% CI 0.29\u20131.78) for symptomatic hypotension and worsening renal function, respectively for ACEi\/ARB na\u00efve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In HF with EF\u2009&amp;gt;40% stabilized after worsening HF, safety and efficacy were similar irrespective of ACEi\/ARB status at baseline, supporting early initiation irrespective of prior ACEi\/ARB use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3579","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T10:44:17Z","timestamp":1736505857000},"page":"1418-1425","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Sacubitril\/Valsartan Versus Valsartan Initiation in Patients Na\u00efve to Renin\u2013angiotensin System Inhibitors: Insights from PARAGLIDE-HF"],"prefix":"10.1093","volume":"27","author":[{"given":"Nina","family":"Nouhravesh","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]},{"name":"Department of Cardiology, Herlev-Gentofte University Hospital , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander H.","family":"Gunn","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Cyr","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian F.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Morrow","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Velazquez","sequence":"additional","affiliation":[{"name":"Yale School of Medicine , New Haven, CT ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Ward","sequence":"additional","affiliation":[{"name":"Novartis Pharmaceuticals Corporation , East Hanover, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samiha","family":"Sarwat","sequence":"additional","affiliation":[{"name":"Novartis Pharmaceuticals Corporation , East Hanover, NJ 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