{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:24:44Z","timestamp":1787203484918,"version":"build-2736575974"},"reference-count":42,"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":[[2026,8,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Durable left ventricular assist devices improve survival in patients with advanced heart failure (HF), yet long\u2010term outcomes remain limited by recurrent decompensation and end\u2010organ dysfunction. Evidence on the prognostic association of angiotensin receptor\u2013neprilysin inhibitor (ARNI) therapy after left ventricular assist device implantation remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We conducted a retrospective multicenter cohort study using the TriNetX Research Network. Adults undergoing durable left ventricular assist device implantation between 2015 and 2025 were identified. Patients receiving ARNI therapy were propensity score matched 1:1 with patients without ARNI exposure. The primary outcome was 1\u2010year major adverse cardiovascular events, defined as a composite of heart failure exacerbation or all\u2010cause mortality. Secondary outcomes included all\u2010cause mortality, heart failure exacerbation, and major adverse kidney events hazards models estimated hazard ratios (HRs) with 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      After matching, 923 patients were included in each group. ARNI use was associated with significantly lower risks of major adverse cardiovascular events (28.8% versus 35.9%; HR 0.71, 95% CI 0.60\u20130.83;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), all\u2010cause mortality (6.7% versus 10.6%; HR 0.57, 95% CI 0.41\u20130.78;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), heart failure exacerbation (26.0% versus 30.2%; HR 0.76, 95% CI 0.64\u20130.91;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002), and major adverse kidney events (5.1% versus 10.4%; HR 0.45, 95% CI 0.32\u20130.64;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Results were consistent across prespecified subgroups and supported by negative control and E\u2010value analyses.\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 with durable left ventricular assist devices support, ARNI therapy was associated with lower cardiovascular and renal event risk. Given the observational design, these findings should be interpreted cautiously and require confirmation in prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048550","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T03:21:55Z","timestamp":1783740115000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Sacubitril\/Valsartan Use and Risk of Major Adverse Cardiovascular Events in Patients With Durable Left Ventricular Assist Devices: A Multi\u2010Institutional Real\u2010World Cohort Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3290-1909","authenticated-orcid":false,"given":"Jheng\u2010Yan","family":"Wu","sequence":"first","affiliation":[{"name":"Chi Mei Medical Center","place":["Tainan, Taiwan"]},{"name":"National Cheng Kung University","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keng\u2010Wei","family":"Lee","sequence":"additional","affiliation":[{"name":"Chi Mei Medical Center","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9914-0102","authenticated-orcid":false,"given":"Sheng\u2010Chi","family":"Huang","sequence":"additional","affiliation":[{"name":"Chi Mei Medical Center","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1723-828X","authenticated-orcid":false,"given":"Yu\u2010Min","family":"Lin","sequence":"additional","affiliation":[{"name":"Chi Mei Medical Center","place":["Tainan, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31828124ad"},{"key":"e_1_3_2_3_2","first-page":"P9","article-title":"Clinical epidemiology of heart failure: public and private health burden","volume":"19","author":"McMurray JJ","year":"1998","unstructured":"McMurray JJ, Petrie MC, Murdoch DR, Davie AP. Clinical epidemiology of heart failure: public and private health burden. Eur Heart J. 1998;19(Suppl P):P9\u2013P16.","journal-title":"Eur Heart J"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.15341"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.12.011"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2211"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjon.2025.04.001"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)01187-2"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000146819.43235.A9"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198706043162301"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.4965"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.13023\/VAD.2018.09"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.08.015"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacbts.2022.05.010"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001435"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/medsci10010002"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.4103\/sja.SJA_543_18"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.004745"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2020.03.002"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.20055"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2098"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.13480"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-59616-2"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-025-05685-0"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.125.043373"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwaf663"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2025.1650514"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvaf014"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2607"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12924"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2025.101598"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2021.06.007"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/0391398821989066"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13247789"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2025.102657"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1501407"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.31083\/j.rcm2408226"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/6231184"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1159\/000541939"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfaf224"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-023-01917-8"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/5584_2018_145"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.048550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T16:33:05Z","timestamp":1787157185000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.048550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":42,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2026,8,18]]}},"alternative-id":["10.1161\/JAHA.125.048550"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.048550","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]},"assertion":[{"value":"2025-12-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e048550"}}