Heart failure & cardiomyopathies
Impact of Insurance Status and Region on Angiotensin Receptor–Neprilysin Inhibitor Prescription During Heart Failure Hospitalizations
Authors' conclusion
Among patients hospitalized between 2017 and 2020 for HFrEF who were prescribed RAS inhibitor therapy at discharge, insurance status, geographic region, and self-reported race were associated with ARNI initiation.
Study context
- Population
- Patients hospitalised for heart failure with reduced ejection fraction (HFrEF) eligible for renin-angiotensin system (RAS) inhibitor at discharge, Get With The Guidelines-HF registry, January 2017 to June 2020
- Participants
- 42,766 admissions
- Exposure
- Angiotensin receptor-neprilysin inhibitor (ARNI) initiation at discharge by insurance status, US region and self-reported race
- Outcome
- Proportion of ARNI prescription at discharge among those prescribed RAS inhibitor not on ARNI on admission
- Follow-up
- Discharge
Methodological detailsregistry-based (Get With The Guidelines-Heart Failure)
- Registry-based (Get With The Guidelines-Heart Failure)
Main finding
As reported in the abstract
ARNI initiation at discharge
Odds ratio (95% CI)
Third-party insurance vs Medicare
0.47(0.31–0.72)
Medicaid vs Medicare
0.41(0.25–0.67)
No insurance vs Medicare
0.20(0.08–0.47)
Black vs Whiteself-reported race
0.64(0.50–0.81)
- ARNI prescribed among discharges on RAS inhibitor (16,817 [94.2%])
- 1,640 (9.8%)
Observational data: associations, not effects.
Original publication
Impact of Insurance Status and Region on Angiotensin Receptor–Neprilysin Inhibitor Prescription During Heart Failure Hospitalizations. JACC Heart Fail. Published 17 April 2024. doi:10.
Summarised from the published abstract; every number is checked against it