{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T15:22:06Z","timestamp":1781104926011,"version":"3.54.1"},"reference-count":16,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ministry of Science and Education of Republic of Kazakhstan","award":["BR11065383-OT-22"],"award-info":[{"award-number":["BR11065383-OT-22"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,1,3]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Heart failure (HF) remains a major public health problem with a high mortality and morbidity worldwide. Currently, there is no optimal revascularisation strategy for patients with ischaemic cardiomyopathy despite suggestions that coronary artery bypass graft (CABG) may be superior to medical therapy in improving survival. However, CABG may be associated with substantial risk in HF subjects. We therefore aimed to evaluate the safety and efficacy of the early initiation of sacubitril\/valsartan in haemodynamically stabilised patients with HF with reduced ejection fraction (HFrEF) after early CABG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was an open-label study in which ~80 patients after CABG were randomised either to the early or late initiation of the sacubitril-valsartan. The study included patients &gt;40 years with left ventricular ejection fraction &lt;45%\u2009and New York Heart Association (NYHA) class II\u2013IV at the early stage after CABG. Patients underwent intervention, the starting dose of sacubitril\/valsartan (24\/26\u2009mg or 49\/51\u2009mg two times per day). The follow-up took place every 4 weeks except the first visit, which took place in 2 weeks after initiation. The primary endpoint assessed the key safety outcomes, the secondary endpoints were: the quality of life measured, the N-terminal pro-B-type natriuretic peptide (NT-proBNP) changes and 6 min walk test (6MWT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 83 patients were screened and 77 patients were enrolled. The majority of patients (84.4%) were in the NYHA class III at randomisation. The number of patients who discontinued the study was low in both groups (2.5%, 5.2%), and renal function, hyperkalaemia and symptomatic hypotension rarely seen in both groups did not differ significantly. The improvement in quality of life and distance at the 6MWT in both groups was significant (p&lt;0.001). The NT-proBNP concentration decreased in both groups, the significant reduction was in the early group (p&lt;0.001) versus the postdischarge group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The early initiation of sacubitril\/valsartan in patients after CABG with HFrEF is safe and effective. Adverse events and permanent discontinuation were low. The NT-proBNP concentration reduced significantly with the early in-hospital initiation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2023-002492","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T06:46:22Z","timestamp":1705560382000},"page":"e002492","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Use of sacubitril\/valsartan early after CABG"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2561-8707","authenticated-orcid":false,"given":"Madina","family":"Nurzhanova","sequence":"first","affiliation":[{"name":"Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan"},{"name":"Kazakhstan Medical University \u2018Graduate School of Public Health\u2019, Almaty, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisulu","family":"Musagaliyeva","sequence":"additional","affiliation":[{"name":"Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raushan","family":"Zhakypova","sequence":"additional","affiliation":[{"name":"Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniya","family":"Senkibayeva","sequence":"additional","affiliation":[{"name":"Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9842-962X","authenticated-orcid":false,"given":"Amina","family":"Rakisheva","sequence":"additional","affiliation":[{"name":"Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,18]]},"reference":[{"key":"2025081612003958000_11.1.e002492.1","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2016"},{"key":"2025081612003958000_11.1.e002492.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01683-7"},{"key":"2025081612003958000_11.1.e002492.3","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.025270"},{"key":"2025081612003958000_11.1.e002492.4","unstructured":"Malik A , Brito D , Chhabra L . Congestive Heart Failure (CHF). Treasure Island: Statpearls, 2020. Available: https:\/\/pubmed.ncbi.nlm.nih.gov\/28613623"},{"key":"2025081612003958000_11.1.e002492.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.hfc.2013.10.002"},{"key":"2025081612003958000_11.1.e002492.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2013.04.012"},{"key":"2025081612003958000_11.1.e002492.7","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy394"},{"key":"2025081612003958000_11.1.e002492.8","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014932"},{"key":"2025081612003958000_11.1.e002492.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1100356"},{"key":"2025081612003958000_11.1.e002492.10","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.024800"},{"key":"2025081612003958000_11.1.e002492.11","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2333"},{"key":"2025081612003958000_11.1.e002492.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.04.025"},{"key":"2025081612003958000_11.1.e002492.13","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.ahj.2018.01.004","article-title":"Rationale and design of the comParIson of sacubitril\/valsartaN versus enalapril on effect on NT-pRo-BNP in patients stabilized from an acute heart failure episode (PIONEER-HF) trial","volume":"198","author":"Velazquez","year":"2018","journal-title":"Am Heart J"},{"key":"2025081612003958000_11.1.e002492.14","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1002\/ehf2.12246","article-title":"Rationale and design of TRANSITION: a randomized trial of pre-discharge vs. post-discharge initiation of sacubitril\/valsartan","volume":"5","author":"Pascual-Figal","year":"2018","journal-title":"ESC Heart Fail"},{"key":"2025081612003958000_11.1.e002492.15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812851"},{"key":"2025081612003958000_11.1.e002492.16","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1498"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2023-002492","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T19:00:48Z","timestamp":1755370848000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2023-002492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,18]]},"published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1136\/openhrt-2023-002492"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2023-002492","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}