{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:03:36Z","timestamp":1789715016522,"version":"4.0.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,4,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Sacubitril\/valsartan is known to reduce adverse renal outcomes and slow the decline in estimated glomerular filtration rate (eGFR) compared with renin\u2010angiotensin system (RAS) inhibitors across the entire spectrum of heart failure. However, whether these renoprotective effects differ by sex has not been elucidated. Thus, we aimed to evaluate whether the treatment effect of sacubitril\/valsartan versus RAS inhibitors on renal outcomes differs by sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Data sets from the PARADIGM\u2010HF (Prospective Comparison of Angiotensin Receptor\u2010Neprilysin Inhibitor With Angiotensin\u2010Converting Enzyme Inhibition to Determine Impact on Global Mortality and Morbidity in Heart Failure; ejection fraction \u226440%, n=8399) and PARAGON\u2010HF (Prospective Comparison of Angiotensin Receptor\u2010Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in Heart Failure With Preserved Ejection Fraction; ejection fraction \u226545%, n=4796) trials were integrated in a prespecified pooled analysis. We evaluated the treatment effect (sacubitril\/valsartan versus RAS inhibitors) on the prespecified renal composite outcome (death from renal failure, end\u2010stage renal disease, or \u226550% reduction in eGFR) and changes in eGFR slope in female (n=4311) and male (n=8884) patients to determine whether sex modified the effect of sacubitril\/valsartan on renal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      At baseline, women exhibited lower eGFR values than men (67.2\u00b119.7 versus 72.6\u00b120.4 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Compared with RAS inhibitors, sacubitril\/valsartan reduced the renal composite outcome similarly in women (1.1% versus 2.2%, hazard ratio [HR], 0.51 [95% CI, 0.31\u20130.83]) and in men (1.0% versus 1.7%, HR, 0.60 [95% CI, 0.41\u20130.86];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      for interaction=0.60). Sacubitril\/valsartan attenuated the decline in eGFR compared with RAS inhibitors similarly in women (\u22121.8 versus \u22122.2 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      per year,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.006) and men (\u22121.6 versus \u22122.3 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      per year,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      for interaction for difference in eGFR slopes=0.19).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Sacubitril\/valsartan significantly reduces the incidence of renal composite outcome and decelerates the decline in eGFR compared with RAS inhibitors. The renoprotective effects of this drug are uniformly observed in both women and men.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047533","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T09:25:02Z","timestamp":1774430702000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Angiotensin\u2010Neprilysin Inhibition and Renal Outcome in Men and Women With Heart Failure"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3336-3612","authenticated-orcid":false,"given":"Wonse","family":"Kim","sequence":"first","affiliation":[{"name":"Seoul National University","place":["Seoul, Republic of Korea"]},{"name":"MetaEyes","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4209-655X","authenticated-orcid":false,"given":"Minjae","family":"Yoon","sequence":"additional","affiliation":[{"name":"Seoul National University Bundang Hospital, Seoul National University College of Medicine","place":["Seongnam, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woong","family":"Kook","sequence":"additional","affiliation":[{"name":"Seoul National University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9611-1490","authenticated-orcid":false,"given":"Jin Joo","family":"Park","sequence":"additional","affiliation":[{"name":"Seoul National University Bundang Hospital, Seoul National University College of Medicine","place":["Seongnam, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6605-9385","authenticated-orcid":false,"given":"Barry","family":"Greenberg","sequence":"additional","affiliation":[{"name":"University of California San Diego","place":["La Jolla, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1908655"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044491"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.038249"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001063"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2016.113"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.36628\/ijhf.2021.0039"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.11.084"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht386"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.116.003825"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2018.02.004"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.120.047643"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2421"},{"key":"e_1_3_1_16_2","unstructured":"Novartis . 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