Switching to Angiotensin Receptor–Neprilysin Inhibitor and Reduced Risk of New-Onset Atrial Fibrillation in Heart Failure with Reduced Ejection Fraction: A Nationwide Propensity Score–Matched Study

Clicks: 23
ID: 328949
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Steady

Ranked #2 of 48 articles by views in European Heart Journal - Cardiovascular Pharmacotherapy

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
AIMS: We investigated whether switching from traditional renin-angiotensin system (RAS) blockade to angiotensin receptor-neprilysin inhibitor (ARNI) is associated with a lower risk of new-onset atrial fibrillation (AF) than continuing RAS blockade in patients with heart failure with reduced ejection fraction (HFrEF) without prior AF. METHODS AND RESULTS: Using data from the Korean National Health Insurance Service (2017-2021), we identified 39,061 patients with HFrEF without prior AF who received either ARNI (n = 12,263) or traditional RAS blockade (n = 26,798). After 1:1 propensity score matching, 9,030 patients were included in each group. The primary outcome was new-onset AF within 1 year. In the propensity score-matched cohort, new-onset AF incidence was lower in the ARNI group (10.73 vs. 12.15 per 100 person-years; hazard ratio [HR] 0.89; 95% confidence interval [CI] 0.81-0.98; P = 0.021). The composite outcome (new-onset AF, ischaemic stroke, or all-cause death) was also reduced (HR 0.85; 95% CI 0.79-0.92; P < 0.001). In competing risk analysis, ARNI was associated with a lower subdistribution hazard of new-onset AF (sHR 0.73; 95% CI 0.58-0.91; P = 0.005). In the unmatched cohort, the HR was 0.85 (95% CI 0.75-0.96) in an exploratory model including age, sex, hypertension, chronic kidney disease, prior ischaemic stroke, socioeconomic status, residential region, and beta-blocker use, and 0.94 (95% CI 0.87-1.02) after adjustment for all measured baseline covariates. CONCLUSION: In this large nationwide cohort of AF-naïve patients with HFrEF, switching to ARNI was associated with a lower risk of short-term new-onset AF than continuing traditional RAS blockade. As this was a retrospective study, further prospective studies are needed to confirm these findings.
Reference Key
openalex_W7213324242 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Young Jun Park, Dong‐Hyuk Cho, Jimi Choi, Jong‐Chan Youn, Mi‐Na Kim, Chan Joo Lee, Jung‐Woo Son, Byung‐Su Yoo
Are you one of these authors? Claim your profile
Journal European Heart Journal - Cardiovascular Pharmacotherapy
Year 2026
DOI
10.1093/ehjcvp/pvag074
URL
https://doi.org/10.1093/ehjcvp/pvag074
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.