Heart failure & cardiomyopathiesCohort study
Status and Timing of Angiotensin Receptor–Neprilysin Inhibitor Implementation in Patients with Heart Failure and Reduced Ejection Fraction: Data from the Swedish Heart Failure Registry
- Registry-based cohort study
- nationwide
Authors' conclusion
In-hospital and early initiation of ARNI are limited in real-world care but still slightly more likely than in outpatients.
Study context
- Population
- Angiotensin receptor-neprilysin inhibitor (ARNI)-naïve patients with HFrEF (EF <40%) in the Swedish heart failure (HF) Registry, 2017–20213,892 hospitalized
- Participants
- 16,486 patients
- Exposure
- Timing and setting of ARNI initiation
- Outcome
- Timing, setting and predictors of ARNI initiation
Main finding
As reported in the abstract
Timing of ARNI initiation after HF hospitalisation
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| ARNI initiation at index date, by setting | Inpatients 8.1% · Outpatients 5.9% |
| ARNI initiation, by HF duration | HF duration <6 months 4.9% · HF duration ≥6 months 9.1% |
- ARNI initiation at index date, by setting: 16 486 HFrEF patients
- ARNI initiation, by HF duration: 10 209 with HF duration <6 months; 5877 with HF duration ≥6 months
ARNI use over time · 2017 to 2021
- ARNI use in 2017
- 8.3%
- ARNI use in 2021
- 26.7%
ARNI initiation, by HF duration
- In HF duration <6 months, inpatient status, lower EF and hypertension predicted initiation; previous ACEi/ARB use associated with less likely initiation
ARNI discontinuation · 1 year
- Discontinuation range across analyses
- 13% and 20%
Original publication
Status and Timing of Angiotensin Receptor–Neprilysin Inhibitor Implementation in Patients with Heart Failure and Reduced Ejection Fraction: Data from the Swedish Heart Failure Registry. Eur J Heart Fail. Published 30 July 2024. doi:10.1002/ejhf.3404
Summarised from the published abstract; every number is checked against it