Heart failure & cardiomyopathies
Real-World Comparative Effectiveness of Sacubitril/Valsartan Versus RAS Inhibition Alone in Patients with De Novo Heart Failure
Main finding · All-cause hospitalization (annual rate)Result — go to the resultIncidence rate ratio 0.81 95% CI 0.75–0.89Authors' conclusion
Among patients with de novo HFrEF, sacubitril/valsartan (compared with that of ACEi/ARB) was associated with fewer all-cause, CV and HF hospitalizations. These findings are consistent with clinical trial evidence suggesting potential benefits of early initiation of sacubitril/valsartan in patients with HFrEF, including those soon after diagnosis.
Study context
- Population
- Adult patients with de novo HF with reduced ejection fraction (HFrEF) (diagnosed ≤30 days) with left ventricular ejection fraction (LVEF) ≤40% first prescribed sacubitril/valsartan or angiotensin-converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), Optum® dataset, United States, 1 January 2016 to 31 March 2020
- Participants
- 3,290 vs 6,580
- Exposure
- Sacubitril/valsartan versus angiotensin-converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB)
- Sacubitril/valsartann = 3,290
- ACEi/ARBn = 6,580reference
- Outcome
- All-cause hospitalization (annual rate)
Methodological detailspropensity score-matched cohorts
- Propensity score-matched cohorts
Main finding
As reported in the abstract
Incidence rate ratio
0.81
95% CI 0.75–0.89
P < 0.001
Sacubitril/valsartanvs ACEi/ARB
IRR 0.81 (95% CI 0.75–0.89); P < 0.001
Observational data: associations, not effects.
Secondary outcomes
| Outcome | IRR (95% CI) | P value | |
|---|---|---|---|
| Cardiovascular (CV) hospitalizations (annual rate) | 0.80 (0.73–0.87) | P < 0.001 | |
| HF hospitalizations (annual rate) | 0.86 (0.78–0.95) | P = 0.002 | |
| 0.512Incidence rate ratio (log scale) |
Baseline characteristics
- Mean (SD) age
- 63 (14) years
- Women
- 34%
- Hypertension
- 67%
- Diabetes
- 33%
- Chronic kidney disease
- 28%
- Baseline characteristics were balanced across treatment groups
Original publication
Real-World Comparative Effectiveness of Sacubitril/Valsartan Versus RAS Inhibition Alone in Patients with De Novo Heart Failure. ESC Heart Fail. Published 30 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →