The optimization of guideline-directed medical therapy during hospitalization among patients with heart failure with reduced ejection fraction in daily clinical practice

Introduction: Hospitalization due to heart failure (HF) progression is associated with poor prognosis. This highlights the role of the implementation of guideline-directed medical therapy (GDMT) in improving the morbidity and mortality of patients with heart failure with reduced ejection fraction (HFrEF). There is limited data about the intrahospital applicability of GDMT in real-world circumstances. We aimed to assess retrospectively the use of cornerstone GDMT including RASi (ACEI/ARB/ARNI), βB, MRA, and SGLT2i treatment in a consecutive real-world HFrEF patient population admitted with signs and symptoms of heart failure to the HF unit of a Hungarian tertiary cardiac centre between 2019 and 2021. The independent predictors of therapy optimization and the applicability of new HFrEF med ication (ARNI, SGLT2i, vericiguat) were also investigated. Methods: Statistical comparison of admission and discharge medication was accomplished with Fisher’s exact test. The independent predictors of the introduction of triple therapy (RASi+βB+MRA) were analyzed using univariate and multivariat e logistic regression. The proportion of patients eligible for vericiguat based on the inclusion and exclusion criteria of the VICTORIA trial was also investigated, as well as the number of patients suitable for ARNI and SGLT2i, taking into account the contraindications of application contained in t he ESC 2021 HF Guidelines. Results: 238 patients were included. During hospitalization, the use o...
Source: Cardiology - Category: Cardiology Source Type: research