Heart failure & cardiomyopathiesCohort study

Contemporary Medical Therapy for Heart Failure Across the Ejection Fraction Spectrum: The OPTIPHARM-HF Registry

Eur J Heart FailPublished

  • Prospective observational registry study
  • multicentre
  • nationwide
  • 32 Italian heart failure (HF) centres

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 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)

Main finding

As reported in the abstract

GDMT prescription at enrolment

Beta-blockers

ACEi/ARB

ARNI

MRA

SGLT2i

OutcomeHFrEFHFmrEFHFpEF
Quadruple therapy47%Not reported in the abstractNot reported in the abstract

Observational data: associations, not effects.

Further findings

OutcomeHFrEFHFmrEFHFpEF
SGLT2i prescription after first visitNot reported in the abstract74%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:10.1002/ejhf.70074

Summarised from the published abstract; every number is checked against it