AIMS: Sub-analysis of a retrospective nation-wide observational analysis of heart failure (HF) epidemiology reported to the Czech National Registry of Reimbursed Health Services between 2012 and 2018 aimed at angiotensin-converting enzyme inhibitors (ACEI), angiotensin-II-receptor antagonists (ARB) and angiotensin receptor blocker/neprilysin inhibitor (ARNI) use. METHODS AND RESULTS: ACEi and ARBs were generally used in 87.6% of all HF patients in 2012 (n=154 627); 84.5% in 2013 (n=170 861); 83.5% in 2014 (n=186 963); 81.6% in 2015 (n=198 844); 80.1% in 2016 (n=205 793); 78.0% in 2017 (n=212 152) and in 76.7% in 2018 (n=219 235). In a sub-analysis of patients with a medical procedure and/or examination using an I50.x ICD code accounted for in the given year, ACEi and ARBs were generally used in 99.3% in 2012 (n=63 250); 96% in 2013 (n=62 241); 95.2% in 2014 (n=64 414); 93.3% in 2015 (n=65 217); 91.8% in 2016 (n=65 236); 90.1% in 2017 (n=65 761) and in 88.6% in 2018 (n=66 332). In 2018, the majority of patients with HF were prescribed ramipril (n=49 909; 17.5%) and perindopril (n=44 332; 15.5%). The mostly prescribed ARBs in 2018 were telmisartan (n=18 669; 6.5%); losartan (n=13 935; 4.9%) and valsartan (n=4 849; 1.7%). In 24.5% of cases, ACEIs and ARBs were prescribed in a fixed combination with another drug. ARNI became gradually more prescribed from 2018 (n=9 659 in November 2020). CONCLUSION: In an analysis of ACEIs, ARBs and ARNIs utilization in all patients treated for heart failure in the given year in the whole country, we found a comparable rate of drug prescription in comparison with specific heart failure registries. This indicates a good translation of current standard of care into common clinical practice. Ramipril and perindopril remained the mostly prescribed ACEIs and telmisartan became the mostly prescribed ARB. Since 2018, ARNIs began to be widely prescribed.

• Keywords
• Czech Republic, European Union, angiotensin-II-receptor antagonists, angiotensin-converting enzyme (ACE) inhibitors, heart failure, sacubitril/valsartan,
• MeSH
• Angiotensins therapeutic use   MeSH
• Angiotensin Receptor Antagonists * therapeutic use   MeSH
• Antihypertensive Agents MeSH
• Angiotensin II Type 2 Receptor Blockers therapeutic use   MeSH
• Angiotensin-Converting Enzyme Inhibitors therapeutic use   MeSH
• Humans MeSH
• Losartan therapeutic use   MeSH
• Neprilysin therapeutic use   MeSH
• Perindopril therapeutic use   MeSH
• Ramipril therapeutic use   MeSH
• Retrospective Studies MeSH
• Heart Failure * drug therapy   epidemiology   MeSH
• Telmisartan therapeutic use   MeSH
• Valsartan therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Names of Substances
• Angiotensins MeSH
• Angiotensin Receptor Antagonists * MeSH
• Antihypertensive Agents MeSH
• Angiotensin II Type 2 Receptor Blockers MeSH
• Angiotensin-Converting Enzyme Inhibitors MeSH
• Losartan MeSH
• Neprilysin MeSH
• Perindopril MeSH
• Ramipril MeSH
• Telmisartan MeSH
• Valsartan MeSH