{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T14:05:56Z","timestamp":1779458756392,"version":"3.53.1"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CGRPG6L0051"],"award-info":[{"award-number":["CGRPG6L0051"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cardiovasc Pharmacol Ther"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The comparative effectiveness of angiotensin-converting enzyme inhibitors (ACEis) versus angiotensin receptor blockers (ARBs) in heart failure with nonreduced ejection fraction (HFnon-rEF) remains uncertain. We evaluated long-term outcomes of these therapies in a real-world cohort following hospitalization for acute heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicenter study (2005-2019) included 5837 patients with HFnon-rEF (left ventricular ejection fraction \u2265 40%). Patients were categorized by discharge prescription into ACEi, ARB, or non-renin-angiotensin system inhibitor (RASi) groups. A 14-day landmark approach ensured pharmacological stabilization and reduced time-related bias. Inverse probability of treatment weighting was used to balance covariates (SMD &lt; 0.1). The primary outcome was a composite of cardiovascular (CV) death or heart failure rehospitalization at 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The primary composite outcome was similar between ARB and ACEi users (adjusted hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.75-1.17;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.556). However, ARB therapy was associated with lower all-cause mortality compared with ACEi (adjusted HR, 0.74; 95% CI, 0.55-0.99;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.041) and non-RASi (adjusted HR, 0.80; 95% CI, 0.67-0.94;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.008). Subgroup analyses showed generally consistent directional associations between ARB use and lower mortality, although these findings were exploratory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real-world cohort of patients with HFnon-rEF, ARB use was associated with lower all-cause mortality compared with ACEi, despite similar CV outcomes. These findings do not establish superiority and should be interpreted as hypothesis-generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10742484261452742","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T12:32:58Z","timestamp":1779280378000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effectiveness of Renin-Angiotensin System Inhibitors in Heart Failure With Nonreduced Ejection Fraction: A Multicenter Cohort Study"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9348-8153","authenticated-orcid":false,"given":"Ming-Shyan","family":"Lin","sequence":"first","affiliation":[{"name":"Chang Gung Memorial Hospital Chiayi Branch"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan"},{"name":"College of Medicine, Chang Gung University, Taoyuan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Chang","family":"Wang","sequence":"additional","affiliation":[{"name":"Chang Gung Memorial Hospital Chiayi Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Jung","family":"Chang","sequence":"additional","affiliation":[{"name":"Chang Gung Memorial Hospital Chiayi Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0361-6348","authenticated-orcid":false,"given":"Pao-Hsien","family":"Chu","sequence":"additional","affiliation":[{"name":"College of Medicine, Chang Gung University, Taoyuan"},{"name":"Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou Branch, Taoyuan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8594-3360","authenticated-orcid":false,"given":"Meng-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Chang Gung Memorial Hospital Chiayi Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Sheng","family":"Lin","sequence":"additional","affiliation":[{"name":"Chang Gung Memorial Hospital Chiayi Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tien-Hsing","family":"Chen","sequence":"additional","affiliation":[{"name":"Chang Gung Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Horng","family":"Tsai","sequence":"additional","affiliation":[{"name":"Chang Gung Memorial Hospital Chiayi Branch"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan"},{"name":"Division of Neonatology and Pediatric Hematology\/Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Yunlin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-0151-7"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2015.134"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-042220-022745"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.122.010080"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14097"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2022-322181"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.707777"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14284"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14199"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2206286"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad344"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12204"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2018.11.019"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.04.019"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2025.106615"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2030183"},{"issue":"18","key":"e_1_3_3_18_2","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: Executive summary: A report of the American College of Cardiology\/American Heart Association Joint Committee on clinical practice guidelines","volume":"145","author":"Heidenreich PA","year":"2022","unstructured":"Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA\/ACC\/HFSA guideline for the management of heart failure: Executive summary: A report of the American College of Cardiology\/American Heart Association Joint Committee on clinical practice guidelines. 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