Heart failure & cardiomyopathies
Clinical impact of guideline-directed medical therapy in patients with left ventricular assist device: an international multicentre study
Authors' conclusion
In this large international study, the use of GDMT in LVAD patients was associated with improved survival, with benefits observed even with single-agent therapy. Despite these benefits, only 30% of patients received optimal triple therapy, highlighting the need for improved implementation strategies and standardized protocols in this population.
Study context
- Population
- Left ventricular assist device (LVAD) patientsfrom 22 centres
- Participants
- 875 patients
- Exposure
- Number of guideline-directed medical therapy (GDMT) prescribed
- Triple therapyn = 261
- No GDMTn = 97reference
- Outcome
- all-cause mortality
- Follow-up
- 6-month
Main finding
As reported in the abstract
Each group vs no GDMTAdjusted hazard ratio (CI)P value
Triple therapy
0.51(0.33–0.75)
P < 0.01Dual therapy
0.39(0.26–0.59)
P < 0.01Single therapy
0.45(0.30–0.67)
P < 0.01Observational data: associations, not effects.
Secondary outcomes
Late ventricular arrhythmias (VAs) (>30 days post-implant)
| aHR (CI) | P value | ||
|---|---|---|---|
| ACE-I/ARBLower risk of late VAs · Secondary outcome | 0.65 (0.50–0.84) | P < 0.01 | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Triple therapy | No GDMT |
|---|---|---|
| GDMT prescription | 29.8% | 11.1% |
| Major LVEDD improvement (≥10 mm reduction)Increased progressively | 66.1% | 51.5% |
Factors associated with lower GDMT prescription rates
- Female sex, diabetes, early VAs, and higher bilirubin levels were associated with lower GDMT prescription rates
Original publication
Clinical impact of guideline-directed medical therapy in patients with left ventricular assist device: an international multicentre study. ESC Heart Fail. Published 22 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →