In‐hospital initiation of sacubitril/valsartan in acute decompensated heart failure: being in the right place at the right time

Abstract

This article refers to 'Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study' by R. Wachter et al., published in this issue on pages 998-1007. < 65 years, SBP ≥ 120 mmHg at baseline, history of hypertension, de novo HF, absence of atrial fibrillation at baseline, an estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m 2 at randomization, and a higher starting dose of sacubitril/valsartan (49/51 mg by mouth twice daily) were independently associated (P < 0.05) with achieving target dose. In contrast, neither prior RAS exposure nor treatment assignment (in-hospital vs. post-discharge initiation

Angiotensin receptor-neprilysin inhibition in patients with acute decompensated heart failure: an expert consensus position paper

“…Despite the inherent limitations of the study [32], TRAN-SITION showed emphatically that soon after hospitalization for AHF, it is feasible to achieve effective doses of sac/val in clinically stable patients within a short timeframe.…”