Evidence mapPaperPMID 41843757Full record

ArticleESC heart failure2026

Long-term outcomes following sacubitril/valsartan therapy for chronic HFrEF: an Italian real-world multicentre study.

Giuseppe Dattilo, Roberto Licordari, Egidio Imbalzano, Antonio Cannata, Piergiuseppe Agostoni, Alberto Aimo, Francesco Barillà, Erberto Carluccio, Michele Ciccarelli, Gianluca Di Bella and 12 more

Abstract readMulticenter Study
In one paragraph

Article in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

22 authors.

Giuseppe DattiloDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Cardiology, University of Messina, Messina, Italy.
Roberto LicordariDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Cardiology, University of Messina, Messina, Italy.
Egidio ImbalzanoDepartment of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n.1, Messina 98125, Italy.ORCID 0000-0003-2656-5467
Antonio CannataBritish Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine, Faculty of Life Science, King's College London, London SW5 9RS, UK.ORCID 0000-0001-7609-6297
Piergiuseppe AgostoniCentro Cardiologico Monzino, IRCCs, Milan, Italy.ORCID 0000-0003-2680-3867
Alberto AimoHealth Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.
Francesco BarillàU.O. Cardiologia, Fondazione Policlinico Tor Vergata, Roma, Italy.
Erberto CarluccioCardiology and Cardiovascular Pathophysiology, S. Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.
Michele CiccarelliDepartment of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy.ORCID 0000-0003-2379-1960
Gianluca Di BellaDepartment of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria n.1, Messina 98125, Italy.ORCID 0000-0001-8933-9884
Frank L DiniIstituto Auxologico Italiano IRCCS, Centro Diagnostico e di Ricerca, Pioltello, Milano, Italy.
Michele EmdinHealth Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.ORCID 0000-0002-8541-1962
Francesco LoriaDepartment of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy.
Massimo MapelliCentro Cardiologico Monzino, IRCCs, Milan, Italy.
Enrica MarianoU.O. Cardiologia, Fondazione Policlinico Tor Vergata, Roma, Italy.
Francesco Paolo NiglioDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Alberto PalazzuoliCardiovascular Diseases Unit Cardio-Thoracic and Vascular Department, S. Maria Alle Scotte Hospital, University of Siena, Siena, Italy.ORCID 0000-0002-6235-984X
Gianpaolo PalmieriDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Simona PavoncelliCardiovascular Diseases Unit Cardio-Thoracic and Vascular Department, S. Maria Alle Scotte Hospital, University of Siena, Siena, Italy.
Elisabetta SalvioniCentro Cardiologico Monzino, IRCCs, Milan, Italy.
Gianluigi SavareseDivision of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0001-7732-0887
Michele CorrealeCardiothoracic Department, Policlinico Riuniti University Hospital, Foggia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsLong-term real-world effects of sacubitril/valsartan (S/V) and the impact of S/V dose reduction or discontinuation are less defined. We assessed longitudinal changes after S/V initiation and the association of dose changes with major adverse cardiovascular events (MACE).

methodsMulticentre retrospective study of 592 HFrEF outpatients starting S/V (83% men; age 68 ± 10 years; LVEF 32 ± 7%). NT-proBNP, Kansas City Cardiomyopathy Questionnaire (KCCQ) and echocardiography were collected at baseline, 12 months, and last follow-up. MACE was analysed with Kaplan-Meier and Cox models.

resultsNT-proBNP decreased from 1000 (494-2333) to 751 (304-1726) and 735 (215-1980) pg/ml (P < .001). KCCQ improved from 53 ± 15 to 62 ± 14 and 66 ± 15 (P < .001). LVEF increased from 32 ± 7 to 36 ± 8 and 37 ± 9% (P < .001) and GLS improved from -10.8 ± 3.2 to -12.3 ± 3.1 and -14.0 ± 2.9% (P < .001). During a median follow-up of 3.72 years, 225 patients (38%) experienced MACE (36 deaths; 134 HF hospitalizations). MACE incidence was higher in patients with S/V discontinuation and with dose reduction (log-rank P = .013 and P = .014). In multivariable Cox analysis, S/V discontinuation [hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.28-1.97; P = .040], change in GLS (HR 0.81, 95% CI 0.67-0.98; P = .028) and change in KCCQ (HR 0.95, 95% CI 0.92-0.98; P = .001) were independently associated with MACE.

conclusionsS/V initiation was associated with sustained improvements in NT-proBNP, quality of life, and cardiac remodelling. S/V discontinuation or dose reduction identified patients at higher MACE risk.

Indexed as

AminobutyratesHeart FailureStroke VolumeTetrazolesVentricular Function, LeftAgedAngiotensin Receptor AntagonistsBiphenyl CompoundsChronic DiseaseDose-Response Relationship, DrugDrug CombinationsEchocardiographyFemaleFollow-Up StudiesHumansItalyAminobutyratesAngiotensin Receptor AntagonistsBiphenyl CompoundsDrug Combinationssacubitril and valsartan sodium hydrate drug combinationTetrazolesValsartanCardiac remodellingGlobal longitudinal strainHeart failure with reduced ejection fractionNT-proBNPReal-world evidenceSacubitril/valsartan

Identifiers

PMID41843757
PMCPMC13122607

What Socratic holds

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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 Socratic graph.