{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:29:45Z","timestamp":1790728185256,"version":"4.1.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"42","license":[{"start":{"date-parts":[[2024,8,31]],"date-time":"2024-08-31T00:00:00Z","timestamp":1725062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Novartis K.K."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The efficacy and safety of early sacubitril\/valsartan (Sac\/Val) initiation after acute heart failure (AHF) has not been demonstrated outside North America. The present study aimed to evaluate the effect of in-hospital Sac\/Val therapy initiation after an AHF episode on N-terminal pro-B-type natriuretic peptide (NT-proBNP) level in Japanese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an investigator-initiated, multicentre, prospective, randomized, open-label, blinded-endpoint pragmatic trial. After haemodynamic stabilization within 7 days after hospitalization, eligible inpatients were allocated to switch from angiotensin-converting enzyme inhibitor or angiotensin receptor blocker to Sac\/Val (Sac\/Val group) or to continue angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (control group). The primary efficacy endpoint was the 8-week proportional change in geometric means of NT-proBNP levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 400 patients were equally randomized, and 376 (median age 75 years, 31.9% women, de novo heart failure rate 55.6%, and median left ventricular ejection fraction 37%) were analysed. The per cent changes in NT-proBNP level geometric means at Weeks 4\/8 were \u221235%\/\u221245% (Sac\/Val group) and \u221218%\/\u221232% (control group), and their group ratio (Sac\/Val vs. control) was 0.80 (95% confidence interval 0.68\u20130.94; P = .008) at Week 4 and 0.81 (95% confidence interval 0.68\u20130.95; P = .012) at Week 8, respectively. In the pre-specified subgroup analyses, the effects of Sac\/Val were confined to patients with a left ventricular ejection fraction &amp;lt; 40% and were more evident in those in sinus rhythm and taking mineralocorticoid receptor antagonists. No adverse safety signal was evident.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In-hospital Sac\/Val therapy initiation in addition to contemporary recommended therapy triggered a greater NT-proBNP level reduction in Japanese patients hospitalized for AHF. These findings may expand the evidence on Sac\/Val therapy in this clinical situation outside North America.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrial.gov (NCT05164653) and Japan Registry of Clinical Trials (jRCTs021210046).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehae561","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T01:59:57Z","timestamp":1723773597000},"page":"4482-4493","source":"Crossref","is-referenced-by-count":25,"title":["In-hospital initiation of angiotensin receptor\u2013neprilysin inhibition in acute heart failure: the PREMIER trial"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3352-7661","authenticated-orcid":false,"given":"Atsushi","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of 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