Heart failure & cardiomyopathiesCohort study
Contemporary Guideline-Directed Medical Therapy in De Novo, Chronic, and Worsening Heart Failure Patients: First Data from the TITRATE-HF Study
- Prospective registry study
- multicentre
- ongoing long-term registry
Authors' conclusion
This first analysis of the TITRATE-HF study reports relatively high use of GDMT in a contemporary HF cohort, while still showing room for improvement regarding quadruple therapy. Importantly, the use and dose of GDMT were suboptimal, with the reasons often remaining unclear.
Study context
- Population
- Patients with heart failure (HF) at 48 hospitals in the Netherlands
- Participants
- 4,288 patients · 48 hospitals
- Exposure
- De novo HF vs Chronic HF vs Worsening HF
- De novo HFn = 1,732
- Chronic HFn = 2,240
- Worsening HFn = 316
- Outcome
- Use, sequencing and titration of GDMT, incl. implementation barriers
Main finding
As reported in the abstract
GDMT use in HFrEF
Chronic and worsening HFrEF prescribed quadruple therapy
44%
HFrEF achieving target dose for all drug classes
1%
Non-use per guideline-directed medical therapy (GDMT) class related to side-effects, intolerances or contraindications
19% to 36%
Observational data: associations, not effects.
Further findings
- Prior GDMT use for non-HF indications (de novo HF)
- 49%
Baseline characteristics
- Median age, years (IQR 63-78)
- 71
- Female
- 29%
- Median EF (IQR 25-40)
- 35%
Original publication
Contemporary Guideline-Directed Medical Therapy in De Novo, Chronic, and Worsening Heart Failure Patients: First Data from the TITRATE-HF Study. Eur J Heart Fail. Published 12 May 2024. doi:10.1002/ejhf.3267
Summarised from the published abstract; every number is checked against it