{"doi":"10.1161/jaha.121.021459","title":"Clinical Effectiveness of Sacubitril/Valsartan Among Patients Hospitalized for Heart Failure With Reduced Ejection Fraction","abstract":"Background Sacubitril/Valsartan has been highly efficacious in randomized trials of heart failure with reduced ejection fraction (HFrEF). However, the effectiveness of sacubitril/valsartan in older patients hospitalized for HFrEF in real‐world US practice is unclear. Methods and Results This study included Medicare beneficiaries age ≥65 years who were hospitalized for HFrEF ≤40% in the Get With The Guidelines–Heart Failure registry between October 2015 and December 2018, and eligible for sacubitril/valsartan. Associations between discharge prescription of sacubitril/valsartan and clinical outcomes were assessed after inverse probability of treatment weighting and adjustment for other HFrEF medications. Overall, 1551 (10.9%) patients were discharged on sacubitril/valsartan. Of those not prescribed sacubitril/valsartan, 7857 (62.0%) were prescribed an angiotensin‐converting enzyme inhibitor/angiotensin II receptor blocker. Over 12‐month follow‐up, compared with a discharge prescription of angiotensin‐converting enzyme inhibitor/angiotensin II receptor blocker, sacubitril/valsartan was independently associated with lower all‐cause mortality (adjusted hazard ratio [HR], 0.82; 95% CI, 0.72–0.94; P =0.004) but not all‐cause hospitalization (adjusted HR, 0.97; 95% CI, 0.89–1.07; P =0.55) or heart failure hospitalization (adjusted HR, 1.04; 95% CI, 0.91–1.18; P =0.59). Patients prescribed sacubitril/valsartan versus those without a prescription had lower risk of all‐cause mortality (adjusted HR, 0.69; 95% CI, 0.60–0.79; P <0.001), all‐cause hospitalization (adjusted HR, 0.90; 95% CI, 0.82–0.98; P =0.02), but not heart failure hospitalization (adjusted HR, 0.94; 95% CI, 0.82–1.08; P =0.40). Conclusions Among patients hospitalized for HFrEF, prescription of sacubitril/valsartan at discharge was independently associated with reduced postdischarge mortality compared with angiotensin‐converting enzyme inhibitor/angiotensin II receptor blocker, and reduced mortality and all‐cause hospitalization compared with no sacubitril/valsartan. These findings support the use of sacubitril/valsartan to improve postdischarge outcomes among older patients hospitalized for HFrEF in routine US clinical practice.","journal":"Journal of the American Heart Association","year":2021,"id":171851,"datarank":0.4943755299006494,"base_score":3.295836866004329,"endowment":3.295836866004329,"self_citation_contribution":0.4943755299006494,"citation_network_contribution":0.0,"self_endowment_contribution":0.4943755299006494,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":26,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8779,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":429074,"name":"Su‐Jung Choi","orcid":null,"position":1,"is_corresponding":false},{"id":331974,"name":"Steven Lippmann","orcid":"0000-0003-2838-1186","position":2,"is_corresponding":false},{"id":274218,"name":"Robert J. Mentz","orcid":"0000-0002-3222-1719","position":3,"is_corresponding":false},{"id":361293,"name":"Melissa A. Greiner","orcid":"0000-0002-3614-5602","position":4,"is_corresponding":false},{"id":503248,"name":"N. Chantelle Hardy","orcid":"0000-0001-6962-6579","position":5,"is_corresponding":false},{"id":126140,"name":"Bradley G. Hammill","orcid":"0000-0002-0389-6434","position":6,"is_corresponding":false},{"id":443824,"name":"Nancy Luo","orcid":"0000-0001-9237-5165","position":7,"is_corresponding":false},{"id":454854,"name":"Marc D. Samsky","orcid":"0000-0001-7524-5174","position":8,"is_corresponding":false},{"id":218313,"name":"Paul A. Heidenreich","orcid":"0000-0001-7730-8490","position":9,"is_corresponding":false},{"id":707233,"name":"Warren K. Laskey","orcid":null,"position":10,"is_corresponding":false},{"id":64843,"name":"Clyde W. Yancy","orcid":"0000-0001-7271-4166","position":11,"is_corresponding":false},{"id":97067,"name":"Pamela N. Peterson","orcid":"0000-0001-6864-2016","position":12,"is_corresponding":false},{"id":503249,"name":"Lesley H. Curtis","orcid":"0000-0002-3286-9371","position":13,"is_corresponding":false},{"id":51666,"name":"Adrian F. Hernandez","orcid":"0000-0003-3387-9616","position":14,"is_corresponding":false},{"id":97058,"name":"Gregg C. Fonarow","orcid":"0000-0002-3192-8093","position":15,"is_corresponding":false},{"id":337848,"name":"Emily C. O’Brien","orcid":"0000-0002-8257-7561","position":16,"is_corresponding":false},{"id":274671,"name":"Stephen J. Greene","orcid":"0000-0001-6912-7374","position":0,"is_corresponding":true}],"reference_count":23,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T23:46:33.067299Z","pmid":"34350772","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}