{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T23:59:51Z","timestamp":1785023991227,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T00:00:00Z","timestamp":1626134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objective<\/jats:title><jats:p>To assess the effectiveness of sacubitril\/valsartan versus angiotensin receptor antagonist therapy for prevention of heart failure (HF)\u2010related hospitalization and all\u2010cause hospitalization in a large cohort of patients with heart failure with reduced ejection fraction (HFrEF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Source<\/jats:title><jats:p>IBM<jats:sup>\u00ae<\/jats:sup> MarketScan<jats:sup>\u00ae<\/jats:sup> research databases (2014\u20132018).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Patients aged 18 years or older with their first HFrEF hospitalization on or after January 1, 2015, who initiated sacubitril\/valsartan or angiotensin receptor antagonist after hospital discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Sacubitril\/Valsartan versus Angiotensin receptor antagonist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>The index date was the first sacubitril\/valsartan or angiotensin receptor antagonist fill date. After 1 up to 3 propensity score matching, Cox proportional hazards regression was used with robust variance estimators to compare HF\u2010related and all\u2010cause hospitalizations between treatments. Subgroup and sensitivity analyses were conducted to assess the robustness of the main analysis. After propensity score matching, 1,088 sacubitril\/valsartan and 2,839 angiotensin receptor antagonist new users were included. The crude incidence of HF\u2010related hospitalization was 13 per 100 person\u2010years for sacubitril\/valsartan users and 18 per 100 person\u2010years for angiotensin receptor antagonist users. Compared with angiotensin receptor antagonist use, sacubitril\/valsartan use was associated with 27% lower risk of HF\u2010related hospitalization (adjusted hazard ratio, 0.73; 95% confidence interval, 0.58\u20130.91; <jats:italic>p<\/jats:italic> = 0.006) and 31% lower risk of all\u2010cause hospitalization (adjusted hazard ratio, 0.69; 95% confidence interval, 0.61\u20130.79; <jats:italic>p<\/jats:italic> &lt; 0.001). Subgroup analyses revealed no significant heterogeneity, including subpopulations with chronic kidney disease or coronary artery disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared with angiotensin receptor antagonists, sacubitril\/valsartan was associated with lower risk of HF\u2010related and all\u2010cause hospitalizations. Our data suggest that, when added sequentially, sacubitril\/valsartan should be the preferred initial agent over angiotensin receptor antagonists.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2610","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T11:31:50Z","timestamp":1624620710000},"page":"710-721","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effectiveness of sacubitril\/valsartan versus aldosterone antagonists in heart failure with reduced ejection fraction: A retrospective cohort study"],"prefix":"10.1002","volume":"41","author":[{"given":"Munaza","family":"Riaz","sequence":"first","affiliation":[{"name":"Pharmaceutical Outcomes and Policy College of Pharmacy University of Florida Gainesville Florida USA"},{"name":"Lahore College for Women University Lahore 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3299-8111","authenticated-orcid":false,"given":"Haesuk","family":"Park","sequence":"additional","affiliation":[{"name":"Pharmaceutical Outcomes and Policy College of Pharmacy University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000757"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198706043162301"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000065187.80707.18"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812851"},{"key":"e_1_2_7_7_1","first-page":"605","article-title":"Aldosterone antagonism in heart 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