{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:40:03Z","timestamp":1777419603208,"version":"3.51.4"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>US guidelines recommend that patients with heart failure with reduced ejection fraction (HFrEF), who tolerate an ACEI (angiotensin-converting enzyme inhibitor) or ARB (angiotensin II receptor blocker), be switched to sacubitril\/valsartan to reduce morbidity and mortality. We compared characteristics and healthcare utilization between Veterans with HFrEF who were switched to sacubitril\/valsartan versus maintained on an ACEI or ARB.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>retrospective cohort study of treated HFrEF (July 2015\u2013June 2017) using Veterans Affairs data. The index date was the first fill for sacubitril\/valsartan and if none, for an ACEI or ARB. Treated HFrEF was defined by (1) left ventricular ejection fraction \u226440%, (2) \u22651 in\/outpatient HF encounter, and (3) \u22651 ACEI or ARB fill, all within 1-year preindex. Poisson regression models were used to compare baseline characteristics and 1:1 propensity score-matched adjusted 4-month follow-up healthcare utilization between sacubitril\/valsartan switchers and ACEI or ARB maintainers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Switchers (1612; 4.2%) were less likely than maintainers (37\u2009065; 95.8%) to have a history of myocardial infarction or hypertension, and more likely to be black, have a lower left ventricular ejection fraction, and higher preindex healthcare utilization. Switchers were less likely to experience follow-up all-cause hospitalizations (11.2% versus 14.0%; risk ratio 0.80 [95% CI, 0.65\u20130.98],\n              <jats:italic>P<\/jats:italic>\n              value 0.035).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Few Veterans with treated HFrEF were switched to sacubitril\/valsartan within the first 2 years of Food and Drug Administration approval. Sacubitril\/valsartan use was associated with a lower risk for all-cause hospitalizations at 4 months follow-up. Reasons for lack of guideline-recommended sacubitril\/valsartan initiation warrant investigation and may reveal opportunities for HFrEF care optimization.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.118.005691","type":"journal-article","created":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T10:00:16Z","timestamp":1573639216000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Characteristics and Healthcare Utilization Among Veterans Treated for Heart Failure With Reduced Ejection Fraction Who Switched to Sacubitril\/Valsartan"],"prefix":"10.1161","volume":"12","author":[{"given":"April F.","family":"Mohanty","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Epidemiology (A.F.M., T.H., O.V.P., P.R.A.), University of Utah School of Medicine, Salt Lake City, UT."},{"name":"Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT (A.F.M., J.L., O.V.P., P.R.A., A.P.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily B.","family":"Levitan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama. (E.B.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Dodson","sequence":"additional","affiliation":[{"name":"Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY (J.A.D.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orly","family":"Vardeny","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School and Minneapolis Veterans Affairs Center for Chronic Disease Outcomes Research, Minneapolis, Minnesota (O.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan B.","family":"King","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences (J.B.K., A.P.B.), University of Utah School of Medicine, Salt Lake City, UT."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"LaFleur","sequence":"additional","affiliation":[{"name":"Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT (A.F.M., J.L., O.V.P., P.R.A., A.P.B.)."},{"name":"Department of Pharmacotherapy, University of UT College of Pharmacy, Salt Lake City, UT (J.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"He","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Epidemiology (A.F.M., T.H., O.V.P., P.R.A.), University of Utah School of Medicine, Salt Lake City, UT."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga V.","family":"Patterson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Epidemiology (A.F.M., T.H., O.V.P., P.R.A.), University of Utah School of Medicine, Salt Lake City, UT."},{"name":"Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT (A.F.M., J.L., O.V.P., P.R.A., A.P.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick R.","family":"Alba","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Epidemiology (A.F.M., T.H., O.V.P., P.R.A.), University of Utah School of Medicine, Salt Lake City, UT."},{"name":"Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT (A.F.M., J.L., O.V.P., P.R.A., A.P.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia A.","family":"Russo","sequence":"additional","affiliation":[{"name":"US Health Economics &amp; Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ (P.A.R.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle E.","family":"Choi","sequence":"additional","affiliation":[{"name":"AbbVie Incorporated, North Chicago, IL (M.E.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam P.","family":"Bress","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences (J.B.K., A.P.B.), University of Utah School of Medicine, Salt Lake City, UT."},{"name":"Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT (A.F.M., J.L., O.V.P., P.R.A., A.P.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000558"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.011"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000509"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000160417.39497.a9"},{"key":"e_1_3_5_7_2","unstructured":"US Department of Veterans Affairs. VA Informatics and Computing Infrastructure (VINCI). Available at http:\/\/www.hsrd.research.va.gov\/for_researchers\/vinci\/. Accessed September 25 2019."},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-017-0580-8"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.013748"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/pst.433"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.118.005400"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.12.018"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.004302"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.0423"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.623"},{"key":"e_1_3_5_16_2","unstructured":"U.S. Department of Veterans Affairs. Health Benefits Copay Rates - Health Benefits. Available at www.va.gov\/healthbenefits\/cost\/copay_rates.asp. Accessed February 18 2018."},{"key":"e_1_3_5_17_2","unstructured":"VA Pharmacy Benefits Management Services. Sacubitril and Valsartan Criteria for Use. Available at https:\/\/www.pbm.va.gov\/PBM\/clincialguidance\/criteriaforuse\/Sacubitril_Valsartan_ENTRESTO_Criteria_for_Use_Rev_Mar_2017.pdf. Accessed September 25 2019."},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-018-0710-4"},{"key":"e_1_3_5_19_2","unstructured":"Huang G Kim S Gasper J Muz B. 2017 Survey of Veteran Enrollees\u2019 Health and Use of Health Care - Data Findings Report. Available at https:\/\/www.va.gov\/HEALTHPOLICYPLANNING\/SoE2017\/VA_Enrollees_Report_Data_Findings_Report2.pdf. Accessed September 25 2019."},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp150800"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.4304"}],"container-title":["Circulation: Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCHEARTFAILURE.118.005691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T01:39:43Z","timestamp":1715564383000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCHEARTFAILURE.118.005691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1161\/CIRCHEARTFAILURE.118.005691"],"URL":"https:\/\/doi.org\/10.1161\/circheartfailure.118.005691","relation":{},"ISSN":["1941-3289","1941-3297"],"issn-type":[{"value":"1941-3289","type":"print"},{"value":"1941-3297","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11]]},"assertion":[{"value":"2019-10-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e005691"}}