{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:39:39Z","timestamp":1788489579597,"version":"build-2803163510"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Sacubitril\/Valsartan has been highly efficacious in randomized trials of heart failure with reduced ejection fraction (HFrEF). However, the effectiveness of sacubitril\/valsartan in older patients hospitalized for HFrEF in real\u2010world US practice is unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This study included Medicare beneficiaries age \u226565\u00a0years who were hospitalized for HFrEF \u226440% in the Get With The Guidelines\u2013Heart Failure registry between October 2015 and December 2018, and eligible for sacubitril\/valsartan. Associations between discharge prescription of sacubitril\/valsartan and clinical outcomes were assessed after inverse probability of treatment weighting and adjustment for other HFrEF medications. Overall, 1551 (10.9%) patients were discharged on sacubitril\/valsartan. Of those not prescribed sacubitril\/valsartan, 7857 (62.0%) were prescribed an angiotensin\u2010converting enzyme inhibitor\/angiotensin II receptor blocker. Over 12\u2010month follow\u2010up, compared with a discharge prescription of angiotensin\u2010converting enzyme inhibitor\/angiotensin II receptor blocker, sacubitril\/valsartan was independently associated with lower all\u2010cause mortality (adjusted hazard ratio [HR], 0.82; 95% CI, 0.72\u20130.94;\n              <jats:italic>P<\/jats:italic>\n              =0.004) but not all\u2010cause hospitalization (adjusted HR, 0.97; 95% CI, 0.89\u20131.07;\n              <jats:italic>P<\/jats:italic>\n              =0.55) or heart failure hospitalization (adjusted HR, 1.04; 95% CI, 0.91\u20131.18;\n              <jats:italic>P<\/jats:italic>\n              =0.59). Patients prescribed sacubitril\/valsartan versus those without a prescription had lower risk of all\u2010cause mortality (adjusted HR, 0.69; 95% CI, 0.60\u20130.79;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), all\u2010cause hospitalization (adjusted HR, 0.90; 95% CI, 0.82\u20130.98;\n              <jats:italic>P<\/jats:italic>\n              =0.02), but not heart failure hospitalization (adjusted HR, 0.94; 95% CI, 0.82\u20131.08;\n              <jats:italic>P<\/jats:italic>\n              =0.40).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Among patients hospitalized for HFrEF, prescription of sacubitril\/valsartan at discharge was independently associated with reduced postdischarge mortality compared with angiotensin\u2010converting enzyme inhibitor\/angiotensin II receptor blocker, and reduced mortality and all\u2010cause hospitalization compared with no sacubitril\/valsartan. These findings support the use of sacubitril\/valsartan to improve postdischarge outcomes among older patients hospitalized for HFrEF in routine US clinical practice.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021459","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T09:05:59Z","timestamp":1628154359000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Clinical Effectiveness of Sacubitril\/Valsartan Among Patients Hospitalized for Heart Failure With Reduced Ejection Fraction"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6912-7374","authenticated-orcid":false,"given":"Stephen J.","family":"Greene","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"},{"name":"Division of Cardiology Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujung","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Lippmann","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3222-1719","authenticated-orcid":false,"given":"Robert J.","family":"Mentz","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"},{"name":"Division of Cardiology Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa A.","family":"Greiner","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. Chantelle","family":"Hardy","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0389-6434","authenticated-orcid":false,"given":"Bradley G.","family":"Hammill","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9237-5165","authenticated-orcid":false,"given":"Nancy","family":"Luo","sequence":"additional","affiliation":[{"name":"Dignity Health Heart and Vascular Institute Sacramento CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7524-5174","authenticated-orcid":false,"given":"Marc D.","family":"Samsky","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"},{"name":"Division of Cardiology Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7730-8490","authenticated-orcid":false,"given":"Paul A.","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"Department of Medicine Veterans Affairs Palo Alto Health Care System Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren K.","family":"Laskey","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of New Mexico School of Medicine Albuquerque NM"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7271-4166","authenticated-orcid":false,"given":"Clyde W.","family":"Yancy","sequence":"additional","affiliation":[{"name":"Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6864-2016","authenticated-orcid":false,"given":"Pamela N.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Colorado, Anschutz Medical Campus Aurora CO"},{"name":"Division of Cardiology Denver Health Medical Center Denver CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3286-9371","authenticated-orcid":false,"given":"Lesley H.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"},{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3387-9616","authenticated-orcid":false,"given":"Adrian F.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"},{"name":"Division of Cardiology Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3192-8093","authenticated-orcid":false,"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ahmanson\u2010UCLA Cardiomyopathy Center University of California Los Angeles Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"},{"name":"Department of Population Health Sciences Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","first-page":"e137","article-title":"2017 ACC\/AHA\/HFSA Focused Update of the 2013 ACCF\/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America","volume":"8","author":"Yancy CW","year":"2017","unstructured":"Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, Drazner MH, Filippatos GS, Fonarow GC, Givertz MM, et al. 2017 ACC\/AHA\/HFSA Focused Update of the 2013 ACCF\/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. 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