{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T10:48:03Z","timestamp":1770461283789,"version":"3.49.0"},"reference-count":28,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiology"],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;\/i&gt;&lt;\/b&gt; The 3-month period after hospitalization for acute cardiac failure is a vulnerable phase with the highest risk of mortality and rehospitalization. Safety and efficacy of early initiation of sacubitril\/valsartan during the index hospitalization for acute decompensated heart failure (ADHF) is unclear. Therefore, we tested whether sacubitril\/valsartan could result in a lower rate of a composite outcome of first hospitalization for heart failure and death from cardiovascular causes compared to inhibition of the renin-angiotensin system alone. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; We enrolled patients hospitalized for ADHF and reduced ejection fraction at 4 sites; patients were divided into a sacubitril\/valsartan group or an angiotensin-converting enzyme inhibitor (ACEI)\/angiotensin receptor blocker (ARB) group. All patients were followed up for 3 months after discharge. The primary endpoint was outcomes as a composite of death from cardiovascular causes and rehospitalization for heart failure. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; In total, 251 patients who received sacubitril\/valsartan and 251 patients who received ACEIs\/ARBs had similar propensity scores and were included and compared. The primary endpoint was reached in 40 patients (15.9%) treated with sacubitril\/valsartan and in 59 patients (23.5%) managed by ACEI\/ARB (HR, 0.650; 95% CI: 0.435\u20130.971; &lt;i&gt;p&lt;\/i&gt; = 0.035). The NYHA class improved in 72.1% of patients in the sacubitril\/valsartan group and in 59.8% of patients in the ACEI\/ARB group (HR, 1.303; 95% CI: 1.097\u20131.548, &lt;i&gt;p&lt;\/i&gt; = 0.004). The key safety outcomes endpoints did not significantly differ. &lt;b&gt;&lt;i&gt;Conclusions:&lt;\/i&gt;&lt;\/b&gt; Among patients hospitalized with ADHF and reduced left ventricular ejection fraction, we observed that sacubitril\/valsartan therapy led to reduction in death from cardiovascular causes and rehospitalizations for heart failure when compared to ACEI\/ARB therapy alone during the vulnerable phase. Our results support that sacubitril\/valsartan may be administered early in the vulnerable phase after ADHF and improves NYHA class. <\/jats:p>","DOI":"10.1159\/000512418","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T21:09:39Z","timestamp":1617052179000},"page":"335-344","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy and Safety of Sacubitril\/Valsartan Therapy for Acute Decompensated Heart Failure with Reduced Ejection Fraction during the Vulnerable Phase: A Multicenter, Assessor-Blinded, Prospective, Observational, Cohort Study"],"prefix":"10.1159","volume":"146","author":[{"given":"Yun","family":"He","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuemei","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingbao","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph 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