Evidence map›Paper›PMID 34612065›Full record

ArticleJournal of the American Heart Association2021

Sacubitril/Valsartan Initiation Among Veterans Who Are Renin-Angiotensin-Aldosterone System Inhibitor Naïve With Heart Failure and Reduced Ejection Fraction.

April F Mohanty, Emily B Levitan, Jordan B King, John A Dodson, Orly Vardeny, James Cook, Jennifer S Herrick, Tao He, Olga V Patterson, Patrick R Alba and 5 more

Open access · goldAbstract read
In one paragraph

Article in Journal of the American Heart Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Observational
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 1 country.

April F MohantyVeterans Affairs Salt Lake City Health Care System Salt Lake City UT.ORCID 0000-0003-4510-9758
Emily B LevitanDepartment of Epidemiology University of Alabama at Birmingham School of Public Health Birmingham AL.ORCID 0000-0002-5429-3852
Jordan B KingDepartment of Population Health Sciences University of Utah School of Medicine Salt Lake City UT.ORCID 0000-0002-6783-7951
John A DodsonLeon H. Charney Division of Cardiology Department of Medicine New York University School of Medicine New York NY.
Orly VardenyUniversity of Minnesota Medical School Minneapolis MN.
James CookVeterans Affairs Salt Lake City Health Care System Salt Lake City UT.ORCID 0000-0002-5242-3975
Jennifer S HerrickVeterans Affairs Salt Lake City Health Care System Salt Lake City UT.ORCID 0000-0001-9257-8843
Tao HeVeterans Affairs Salt Lake City Health Care System Salt Lake City UT.
Olga V PattersonVeterans Affairs Salt Lake City Health Care System Salt Lake City UT.ORCID 0000-0002-8717-5975
Patrick R AlbaVeterans Affairs Salt Lake City Health Care System Salt Lake City UT.ORCID 0000-0002-5176-5447
Patricia A RussoUS Health Economics & Outcomes Research Novartis Pharmaceuticals CorporationEast Hanover NJ.
Engels N ObiUS Health Economics & Outcomes Research Novartis Pharmaceuticals CorporationEast Hanover NJ.ORCID 0000-0002-1807-3465
Michelle E ChoiNow with Sanofi Bridgewater NJ.
James C FangDepartment of Internal Medicine University of Utah School of Medicine Salt Lake City UT.ORCID 0000-0003-2427-9504
Adam P BressVeterans Affairs Salt Lake City Health Care System Salt Lake City UT.ORCID 0000-0002-2259-5039
University of Utah · USNovartis (United States) · USKaiser Permanente · USNew York University · USSanofi (United States) · USUniversity of Alabama at Birmingham · USUniversity of Minnesota Medical Center · US

Funding

HSRD VA IK2 HX002609
6 · The paper itself

Abstract

Background Sacubitril/valsartan, a first-in-class angiotensin receptor neprilysin inhibitor, received US Food and Drug Administration approval in 2015 for heart failure with reduced ejection fraction (HFrEF). Our objective was to describe the sacubitril/valsartan initiation rate, associated characteristics, and 6-month follow-up dosing among veterans with HFrEF who are renin-angiotensin-aldosterone system inhibitor (RAASi) naïve. Methods and Results Retrospective cohort study of veterans with HFrEF who are RAASi naïve defined as left ventricular ejection fraction (LVEF) ≤40%; ≥1 in/outpatient heart failure visit, first RAASi (sacubitril/valsartan, angiotensin-converting enzyme inhibitor [ACEI]), or angiotensin-II receptor blocker [ARB]) fill from July 2015 to June 2019. Characteristics associated with sacubitril/valsartan initiation were identified using Poisson regression models. From July 2015 to June 2019, we identified 3458 sacubitril/valsartan and 29 367 ACEI or ARB initiators among veterans with HFrEF who are RAASi naïve. Sacubitril/valsartan initiation increased from 0% to 26.5%. Sacubitril/valsartan (versus ACEI or ARB) initiators were less likely to have histories of stroke, myocardial infarction, or hypertension and more likely to be older and have diabetes mellitus and lower LVEF. At 6-month follow-up, the prevalence of ≥50% target daily dose for sacubitril/valsartan, ACEI, and ARB initiators was 23.5%, 43.2%, and 47.1%, respectively. Conclusions Sacubitril/valsartan initiation for HFrEF in the Veterans Administration increased in the 4 years immediately following Food and Drug Administration approval. Sacubitril/valsartan (versus ACEI or ARB) initiators had fewer baseline cardiovascular comorbidities and the lowest proportion on ≥50% target daily dose at 6-month follow-up. Identifying the reasons for lower follow-up dosing of sacubitril/valsartan could support guideline recommendations and quality improvement strategies for patients with HFrEF.

Indexed as

Heart FailureVeteransAldosteroneAminobutyratesAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsBiphenyl CompoundsHumansRenin-Angiotensin SystemRetrospective StudiesStroke VolumeTetrazolesValsartanVentricular Function, LeftAldosteroneAminobutyratesAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsBiphenyl CompoundssacubitrilTetrazolesValsartanangiotensin receptor neprilysin inhibitorheart failuremedicationreduced ejection fractiontitration

Identifiers

PMID34612065
PMCPMC8751890
OpenAlexW3202736123

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.