Heart failure & cardiomyopathiesCohort study
Impact of Insurance Status and Region on Angiotensin Receptor–Neprilysin Inhibitor Prescription During Heart Failure Hospitalizations
- Retrospective cohort study
- registry-based (Get With The Guidelines-Heart Failure)
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
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:10.1016/j.jchf.2024.02.003
Summarised from the published abstract; every number is checked against it