{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:47:50Z","timestamp":1789055270397,"version":"build-2803163510"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,7,18]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">PARAGON\u2010HF (Efficacy and Safety of LCZ696 Compared to Valsartan, on Morbidity and Mortality in Heart Failure Patients With Preserved Ejection Fraction) suggested a potential benefit of sacubitril\u2013valsartan in women with preserved ejection fraction. Among patients with heart failure previously treated with angiotensin\u2010converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), we studied whether effectiveness of treatment with sacubitril\u2013valsartan compared with ACEI\/ARB monotherapy differed between men and women for both preserved and reduced ejection fraction.<\/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              Data were derived from the Truven Health MarketScan Databases between January 1, 2011, and December 31, 2018. We included patients with a primary diagnosis of heart failure on treatment with ACEIs, ARBs, or sacubitril\u2013valsartan on the basis of the first prescription after diagnosis. A total of 7181 patients treated with sacubitril\u2013valsartan, 25\u2009408 patients using an ACEI, and 16\u2009177 patients treated with ARBs were included. A total of 790 readmissions or deaths occurred among 7181 patients in the sacubitril\u2013valsartan group and 11\u2009901 events in 41\u2009585 patients treated with an ACEI\/ARB. Adjusted for covariates, the hazard ratio (HR) for treatment with sacubitril\u2013valsartan compared with an ACEI or ARB was 0.74 (95% CI, 0.68\u20130.80). The protective effect of sacubitril\u2013valsartan was evident for men and women (women: HR, 0.75 [95% CI, 0.66\u20130.86];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01; men: HR, 0.71 [95% CI, 0.64\u20130.79];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01;\n              <jats:italic>P interaction<\/jats:italic>\n              0.03). A protective effect for both sexes was seen only among those with systolic dysfunction.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Treatment with sacubitril\u2013valsartan is more effective at reducing death and admission to the hospital for heart failure compared with ACEIs\/ARBs similarly among men and women with systolic dysfunction; sex differences in the effectiveness of sacubitril\u2013valsartan in diastolic dysfunction requires further investigation.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.028865","type":"journal-article","created":{"date-parts":[[2023,7,8]],"date-time":"2023-07-08T11:26:18Z","timestamp":1688815578000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Sex Differences in the Effectiveness of Angiotensin\u2010Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers, and Sacubitril\u2013Valsartan for the Treatment of Heart Failure"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0770-4962","authenticated-orcid":false,"given":"Zahra N.","family":"Sohani","sequence":"first","affiliation":[{"name":"Department of Medicine McGill University Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Behlouli","sequence":"additional","affiliation":[{"name":"The Research Institute of the McGill University Health Centre Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2109-0709","authenticated-orcid":false,"given":"Cristiano Soares","family":"de Moura","sequence":"additional","affiliation":[{"name":"The Research Institute of the McGill University Health Centre Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Abrahamowicz","sequence":"additional","affiliation":[{"name":"The Research Institute of the McGill University Health Centre Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6159-0628","authenticated-orcid":false,"given":"Louise","family":"Pilote","sequence":"additional","affiliation":[{"name":"The Research Institute of the McGill University Health Centre Montreal Quebec Canada"},{"name":"Department of Epidemiology, Occupational Health, and Biostatistics McGill University Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2016:25:2"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz835"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.037369"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.CJCA.2021.07.003"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-015-6599-0"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.12.033"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.812172"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2010.165"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.98.21.2282"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.081197"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.492033"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.22917"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812851"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1908655"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2021.01.017"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1159\/000498984"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.08.003"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.022"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2021.01.013"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1214\/09-STS313"}],"container-title":["Journal of the American Heart 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