Heart failure & cardiomyopathies
Contemporary Medical Therapy for Heart Failure Across the Ejection Fraction Spectrum: The OPTIPHARM-HF Registry
Authors' conclusion
Use of GDMT remains suboptimal across the EF spectrum although the adoption of quadruple GDMT in HFrEF and of SGLT2i in HFmrEF and HFpEF increased in recent years.
Study context
- Population
- Adults with heart failure (HF) across the ejection fraction (EF) spectrum, 32 Italian HF centres, September 2022 to December 202456% HFrEF, 21% HFmrEF, 23% HFpEF
- Participants
- 3,054 adults
- Exposure
- HFrEF vs HFmrEF vs HFpEF
- Outcome
- Guideline-directed medical therapy (GDMT) use, dosing and implementation (prescription prevalence and change after first visit)
Methodological detailsmulticentre, nationwide, 32 Italian HF centres
- Multicentre
- Nationwide
- 32 Italian HF centres
Main finding
As reported in the abstract
GDMT prescription at enrolment
Beta-blockers
ACEi/ARB
ARNI
MRA
SGLT2i
| Outcome | HFrEF | HFmrEF | HFpEF |
|---|---|---|---|
| Quadruple therapy | 47% | — not stated in the abstract | — not stated in the abstract |
— not stated in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HFmrEF | HFpEF |
|---|---|---|
| SGLT2i prescription after first visit | 74% | 54% |
- SGLT2i prescription after first visit: HFmrEF p < 0.001
- SGLT2i prescription after first visit: HFpEF p < 0.001
Quadruple therapy after first visit (HFrEF)
- Increase in prescription of all drug classes; titration to quadruple therapy attained
- 64%
- p < 0.001
Original publication
Contemporary Medical Therapy for Heart Failure Across the Ejection Fraction Spectrum: The OPTIPHARM-HF Registry. Eur J Heart Fail. Published 17 December 2025. doi:10.
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