Evidence map›Paper›PMID 37906294›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2024

Sacubitril/valsartan and the risk of incident dementia in heart failure: a nationwide propensity-matched cohort study.

Hyun-Jung Lee, Hyung-Kwan Kim, Bong-Seong Kim, Kyung-Do Han, Soongu Kwak, Chan Soon Park, Tae-Min Rhee, Jun-Bean Park, Heesun Lee, Yong-Jin Kim

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Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
2.9field-weighted citation impact, top 8% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Clinical outcomes according to the average daily dose of sacubitril/valsartan: a nationwide longitudinal cohort study.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
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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

10 authors at 4 institutions in 2 countries.

Hyun-Jung LeeSection of Cardiovascular Imaging, Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, 10103080, Korea.
Hyung-Kwan KimSection of Cardiovascular Imaging, Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, 10103080, Korea. cardiman73@gmail.com.ORCID http://orcid.org/0000-0001-7950-2131
Bong-Seong KimDepartment of Statistics and Actuarial Science, Soongsil University, 369, Sangdo-ro, Dongjak-gu, Seoul, Korea.
Kyung-Do HanDepartment of Statistics and Actuarial Science, Soongsil University, 369, Sangdo-ro, Dongjak-gu, Seoul, Korea.
Soongu KwakSection of Cardiovascular Imaging, Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, 10103080, Korea.
Chan Soon ParkSection of Cardiovascular Imaging, Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, 10103080, Korea.
Tae-Min RheeDivision of Cardiology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, 152, Teheran-ro, Gangnam-gu, Seoul, Korea.
Jun-Bean ParkSection of Cardiovascular Imaging, Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, 10103080, Korea.
Heesun LeeDivision of Cardiology, Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, 152, Teheran-ro, Gangnam-gu, Seoul, Korea.
Yong-Jin KimSection of Cardiovascular Imaging, Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, 10103080, Korea.
Seoul National University Hospital · KRSoongsil University · KRYonsei University · KRNew Generation University College · ET

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSacubitril acts to inhibit neprilysin and as neprilysin is involved in amyloid-beta degradation in the central nervous system, and there is concern that sacubitril/valsartan may increase the risk of dementia. We aimed to compare the risk of incident dementia associated with sacubitril/valsartan and angiotensin II receptor blockers (ARBs).

methodsPatients with heart failure with reduced ejection fraction treated with either sacubitril/valsartan or ARB, identified from the Korean National Health Insurance Service database, were matched in a 1:2 ratio using propensity scores (6789 on sacubitril/valsartan and 13,578 on ARBs) and followed up for incident dementia.

resultsDuring a mean follow-up of 2.5 years, 526 (2.6%) patients were newly diagnosed with dementia: Alzheimer dementia in 282, vascular dementia in 8, and other dementia in 236. There was no significant difference in the risk of overall dementia (hazard ratio [HR] 0.84, 95% confidence interval [CI] 0.70-1.01), Alzheimer dementia (HR 0.85, 95% CI 0.67-1.10), vascular dementia (HR 0.98, 95% CI 0.23-4.11), and all other dementias (HR 0.81, 95% CI 0.62-1.07) between sacubitril/valsartan users and ARB users. These results were consistent regardless of initial sacubitril/valsartan dose and subgroups including old age, previous mild cognitive impairment, previous stroke, and concomitant antiplatelet or anticoagulation. Sensitivity analysis with a 1-year lag period for dementia assessment confirmed the main analysis. Meanwhile, risk of incident stroke was lower in sacubitril/valsartan users compared to ARBs users.

conclusionsIn a nationwide propensity-matched cohort of patients with heart failure, sacubitril/valsartan was not associated with an increased risk of incident dementia compared to ARBs.

Indexed as

AminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsDementiaDrug CombinationsHeart FailurePropensity ScoreTetrazolesValsartanAgedAged, 80 and overFemaleFollow-Up StudiesHumansIncidenceMaleAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug CombinationsNeprilysinsacubitril and valsartan sodium hydrate drug combinationTetrazolesValsartanAdverse drug eventDementiaHeart failureNeprilysin

Identifiers

PMID37906294
OpenAlexW4388042981

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.