DeVore AD, Braunwald E, Morrow DA, et al. - Given good tolerability of in-hospital initiation of sacubitril/valsartan as well as improved outcomes associated with this approach vs enalapril in stabilized patients with acute decompensated heart failure (ADHF) in PIONEER-HF trial (a multicenter, randomized, double-blind, active-controlled trial performed at 129 US sites between May 2016 and May 2018), researchers assessed alterations in N-terminal pro–B-type natriuretic peptide (NT-proBNP) concentrations in patients recently hospitalized for ADHF and switching from receiving enalapril to receiving sacubitril/valsartan following discharge, as well as compared clinical results for those randomized to receive in-hospital initiation of sacubitril/valsartan vs in-hospital initiation of enalapril who later switched to receiving sacubitril/valsartan during an open-label extension phase. In the PIONEER-HF trial, a comparison of in-hospital start of sacubitril/valsartan vs enalapril (titrated to target dose, 10 mg twice daily) for 8 weeks was performed in patients admitted for ADHF with decreased ejection fraction and hemodynamic stability. According to the findings, a further 37% decrease in NT-proBNP levels among patients with heart failure with reduced ejection fraction and a recent hospitalization for ADHF was evident as a consequence of switching patients’ treatment from enalapril to sacubitril/valsartan at 8 weeks post-randomization.