Safety and Tolerability of Angiotensin Receptor-Neprilysin Inhibitor Initiation in High-Risk Acute Myocardial Infarction Relative to Care Setting: A Subgroup Analysis of the PARADISE-MI Trial.

Competing Interests: Dr De Pasquale reports research funding from AstraZeneca and Novartis; consulting fees or speaker honoraria from AstraZeneca, Novartis, Vifor, Boehringer Ingelheim, Bayer, Eli Lilly, and Roche. Dr Claggett reports statistical consulting at Alnylam, Cardurion, Corvia, CVRx, Cytokinetics, Intellia, and Rocket. Dr McMurray received support from British Heart Foundation Centre of Research Excellence grant RE/18/6/34217 and the Vera Melrose Heart Failure Research Fund; has received payments through the Glasgow University from work on clinical trials, consulting, and other activities from Amgen, AstraZeneca, Bayer, Cardurion, Cytokinetics, GlaxoSmithKline (GSK), KBP Biosciences, and Novartis; has received personal consulting fees from Alnylam Pharma, Bayer, Bristol Myers Squibb (BMS), George Clinical Pty Ltd, Ionis Pharma, Novartis, Regeneron Pharma, and River 2 Renal Corporation; has received personal lecture fees from Abbott, Alkem Metabolics, AstraZeneca, Blue Ocean Scientific Solutions Ltd, Boehringer Ingelheim, Canadian Medical and Surgical Knowledge, Emcure Pharma Ltd, Eris Lifesciences, European Academy of CME, Hikma Pharmaceuticals, Imagica Health, Intas Pharma, J.B. Chemicals and Pharma Ltd, Lupin Pharma, Medscape/Heart.Org, ProAdWise Communications, Radcliffe Cardiology, Sun Pharma, The Corpus, Translation Research Group, and Translational Medicine Academy; and is a director of Global Clinical Trial Partners Ltd. Dr Granger reports consulting fees from Abbvie, Abiomed, Alnylam Pharmaceuticals, Anthos, Bayer Corporation, Boehringer Ingelheim, Boston Scientific Corporation, BMS, Cardionomics, CeleCor Therapeutics, Janssen Pharmaceutical, Merck, Novo Nordisk, Novartis Pharmaceutical Company, Pfizer, Philips, Reata, and NephroSynergy; salary funded by Duke; grants sponsored by Alnylam, Boehringer Ingelheim, BMS, Daiichi Sankyo, Food and Drug Administration, Janssen Pharmaceuticals, National Institutes of Health (NIH), Novartis Pharmaceutical Company, Pfizer, and Philips; and equity in Tenac.io. Dr Køber reports speaker honoraria from AstraZeneca, Bayer, Boehringer, Novartis, and Novo Nordisk. Dr Maggioni reports personal fees for participation in studies from AstraZeneca, Bayer, Novartis, and Sanofi, outside the present work. Dr Rouleau reports DMC membership with Novartis, BMS, Bayer, and AstraZeneca. Dr Solomon reports research grants from Alnylam, AstraZeneca, Bellerophon, Bayer, BMS, Cytokinetics, Eidos, Gossamer, GSK, Ionis, Lilly, MyoKardia, NIH/National Heart, Lung, and Blood Institute (NHLBI), Novartis, Novo Nordisk, Respicardia, Sanofi Pasteur, Theracos, and US2.AI; and consulted for Abbott, Action, Akros, Alnylam, Amgen, Arena, AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Cardior, Cardurion, Corvia, Cytokinetics, Daiichi Sankyo, GSK, Lilly, Merck, Myokardia, Novartis, Roche, Theracos, Quantum Genomics, Cardurion, Janssen, Cardiac Dimensions, Tenaya, Sanofi Pasteur, Dinaqor, Tremeau, CellProThera, Moderna, American Regent, Sarepta, Lexicon, Anacardio, Akros, and Valo. Dr Steg reports research grants from Amarin and Sanofi; clinical trials (Steering Committee, CEC, DSMB) at Amarin, Amgen, AstraZeneca, Bayer, BMS, Idorsia, Janssen, Novartis, and Sanofi; consulting or speaking at Amarin, Amgen, BMS, Novartis, and Novo Nordisk; and senior associate editor at Circulation. Dr van der Meer is supported by a grant from the European Research Council (ERC CoG 101045236, DISSECT-HF). The UMCG, which employs Dr van der Meer, received consultancy fees and grants from Novartis, Pharmacosmos, Vifor Pharma, AstraZeneca, Pfizer, Pharma Nord, BridgeBio, Novo Nordisk, Daiichi Sankyo, Boehringer Ingelheim, and Ionis. Dr Braunwald has received research grants through his institution from AstraZeneca, Daiichi Sankyo, Merck, and Novartis; and has consultancies with Amgen, BMS, Boehringer Ingelheim/Lilly, Cardurion, and Verve. Dr Pfeffer reports research grant support (via institution) from Lexicon and Novartis; consultant at Alnylam, AstraZeneca, Boehringer Ingelheim and Eli Lilly Alliance, Lexicon, NHLBI CONNECTs (Master Protocol Committee), Novartis, Novo Nordisk, and Sanofi; and has equity in DalCor. The other authors report no conflicts.