{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:50:30Z","timestamp":1790862630060,"version":"4.1.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>Background: Initiation of sacubitril-valsartan and mineralocorticoid receptor antagonists (MRA) during hospitalization for acute decompensated heart failure (ADHF) may be an ideal time to optimize guideline-directed medical therapy. However, there is limited research assessing the safety of combining these agents in the hospital. Methods: This was a multi-center, retrospective, propensity-score matched cohort study performed at 7 acute-care hospitals within a large health care system. All adult patients admitted with ADHF between January 1, 2019 to December 31, 2021 who received sacubitril-valsartan with MRA (MRA group) or without MRA (non-MRA group) and had a left ventricular ejection fraction (LVEF) &lt; 40% were included in the study. Results: 220 patients were screened during the study time frame with 179 meeting inclusion criteria. Following propensity-score matching, 50 patients in the MRA group were matched to 50 patients in the non-MRA group. The overall incidence of adverse drug reactions (ADRs) was 24% in the non-MRA group compared to 20% in the MRA group ( P = .629). There was a significantly greater incidence of hyperkalemia in the MRA group (0% vs 10%; P = .022). None of the patients in the non-MRA group were readmitted within 30 days due to an ADR compared to 6% in the MRA group ( P = .079). Conclusion: The addition of spironolactone to sacubitril-valsartan in the hospital setting following stabilization of ADHF did not lead to a significantly greater incidence of overall ADRs, but patients were more likely to develop hyperkalemia and there was a numerically higher incidence of 30-day readmissions due to ADRs.<\/jats:p>","DOI":"10.1177\/08971900241262382","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T11:53:56Z","timestamp":1721303636000},"page":"43-51","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Safety and Tolerability of Initiating Sacubitril-Valsartan With Spironolactone During Hospitalization for Acute Decompensated Heart Failure"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8838-1332","authenticated-orcid":false,"given":"Alexander R.","family":"Levine","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Hospital of Central Connecticut, New Britain, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Sasiela","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, MidState Medical Center, Meriden, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Saint Vincent\u2019s Medical Center, Bridgeport, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,7,18]]},"reference":[{"key":"bibr1-08971900241262382","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001063"},{"key":"bibr2-08971900241262382","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.022"},{"key":"bibr3-08971900241262382","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.2822"},{"key":"bibr4-08971900241262382","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2022.08"},{"key":"bibr5-08971900241262382","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1351"},{"key":"bibr6-08971900241262382","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)02076-1"},{"key":"bibr7-08971900241262382","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040135"},{"key":"bibr8-08971900241262382","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvab031"},{"key":"bibr9-08971900241262382","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.4733"},{"key":"bibr10-08971900241262382","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812851"},{"key":"bibr11-08971900241262382","volume-title":"IBM SPSS Statistics for Windows, Version 28.0","author":"IBM Corp. 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