Evidence map›Paper›PMID 39368020›Full record

Observational studyHeart and vessels2025

Global use of angiotensin receptor neprilysin inhibitor in heart failure and reduced, below normal and supranormal ejection fraction.

Yu Horiuchi, Masahiko Asami, Kazuyuki Yahagi, Asahi Oshima, Yuki Gonda, Daiki Yoshiura, Kota Komiyama, Hitomi Yuzawa, Jun Tanaka, Jiro Aoki and 1 more

Abstract readObservational StudyMulticenter Study
PubMed Publisher
In one paragraph

Observational study in Heart and vessels, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

11 authors.

Yu HoriuchiDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan. yooouyou@gmail.com.ORCID http://orcid.org/0000-0001-9053-1099
Masahiko AsamiDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan.
Kazuyuki YahagiDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan.
Asahi OshimaDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan.
Yuki GondaDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan.
Daiki YoshiuraDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan.
Kota KomiyamaDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan.
Hitomi YuzawaDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan.
Jun TanakaDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan.
Jiro AokiDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan.
Kengo TanabeDivision of Cardiology, Mitsui Memorial Hospital, Kanda-Izumicho 1, Chiyoda-Ku, Tokyo, 101-8643, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe global use of angiotensin receptor neprilysin inhibitor (ARNI) in clinical practice, especially in patients with heart failure and below-normal ejection fraction (HFbnEF), has not been thoroughly evaluated. We aimed to investigate the characteristics, outcomes, and adverse events in patients treated with ARNI for HF with reduced (HFrEF), below-normal (HFbnEF), and supranormal left ventricular EF (HFsnEF).

methodsThis observational study analyzed data from the electronic healthcare records (EHR) of patients with HF treated with ARNI between 2015 and 2022 in North and South America, Europe, the Middle East, Africa, and Asia-Pacific. Based on the left ventricular EF, patients were categorized as HFrEF (< 40%), HFbnEF (40-60%), and HFsnEF (> 60%). Mortality and the incidence of adverse events were investigated.

resultsOf the 11,141 patients analyzed, HFrEF, HFbnEF and HFsnEF accounted for 74%, 22%, and 4%, respectively. Patients with a higher EF were more likely to be older, female, and obese. Hypertension and atrial fibrillation were the most common in HFsnEF. Systolic blood pressure was lower and natriuretic peptide levels were higher in the lower EF groups. Mortality was lowest in HFbnEF (7.7 per 100 patient-years follow-up in HFrEF, 5.8 in HFmrEF, and 6.0 in HFsnEF). Similarly, hypotension and acute kidney injury were the least frequent in HFbnEF. Incidence of elevated serum potassium levels was similar between the groups.

conclusionsIn this analysis of large-scale EHR, ARNI was mainly used in HFrEF and HFbnEF, consistent with previous randomized trials and pooled analyses. Adverse events were less common in HFbnEF.

Indexed as

AminobutyratesAngiotensin Receptor AntagonistsHeart FailureNeprilysinStroke VolumeVentricular Function, LeftAgedBiphenyl CompoundsDrug CombinationsFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeValsartanAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug CombinationsNeprilysinsacubitril and valsartan sodium hydrate drug combinationValsartanARNIHFbnEFHFrEFHFsnEFPrognosis

Identifiers

What OpenQuestion holds

Textmetadata
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.