{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:52:13Z","timestamp":1791237133085,"version":"4.1.0"},"reference-count":94,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Novartis Pharma AG, Basel, Switzerland"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Sacubitril\/valsartan (Sac\/Val) represents a cornerstone of heart failure (HF) with reduced ejection fraction (HFrEF) management. This systematic review provides a comprehensive overview of real-world evidence (RWE) regarding the implementation, clinical effectiveness, and safety of Sac\/Val in patients with HFrEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search of PubMed was conducted through March 2024 following PRISMA guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The review included 45 manuscripts from 30 different studies, primarily from Europe (44%) and the US (30%). RWE confirmed that Sac\/Val was associated with a lower risk of cardiovascular mortality (10%-16%), HF hospitalization (10%-38%), and all-cause mortality (10%-25%). Sac\/Val was significantly associated with cardiac reverse remodeling and lower-grade mitral regurgitation. Despite these benefits, implementation gaps persist, with only 15%-25% of patients achieving target doses in clinical practice. The most common reported adverse event with Sac\/Val was hypotension (up to 17.6%), though severe hyperkalaemia and renal decline were similar when compared with traditional renin angiotensin system inhibitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Real-world data mirror the efficacy and safety profiles seen in randomized controlled trials, establishing Sac\/Val as a cornerstone of HFrEF therapy. However, significant barriers remain, including delayed initiation and suboptimal dose titration. Enhancing clinician and patient awareness is needed to bridge these implementation gaps and fully realize the drug\u2019s potential to reduce the global healthcare burden of HF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag095","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T11:33:27Z","timestamp":1774956807000},"source":"Crossref","is-referenced-by-count":3,"title":["Ten years real-world experience with sacubitril\/valsartan in patients with heart failure with reduced ejection fraction"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7732-0887","authenticated-orcid":false,"given":"Gianluigi","family":"Savarese","sequence":"first","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet , Sjukhusbacken 10, Stockholm 11883 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