Acute cardiac care & resuscitation
Guideline-Directed Medical Therapy Implementation During Hospitalization for Cardiogenic Shock
Authors' conclusion
Most patients who survived CS admission with HFrEF in this single-centre CS registry were not prescribed all classes or goal doses of GDMT at hospital discharge.
Study context
- Population
- Patients surviving hospitalization for cardiogenic shock with HFrEF, Inova single-centre shock registry, January 2017 to December 2019of 520 cardiogenic shock (CS) patients
- Participants
- 185 patients
- Exposure
- Guideline-directed medical therapy (GDMT) utilization at discharge in CS survivors with HFrEF
- Outcome
- Use of GDMT during CS admission and short-term outcomes
Methodological detailssingle-centre, registry, Data collected by retrospective chart review
- Single-centre
- Registry
- Data collected by retrospective chart review
Main finding
As reported in the abstract
GDMT at discharge
- Beta-blockers
- 78% (n = 144)
- ACEi/ARB/ARNI
- 58% (n = 107)
- MRA
- 55% (n = 101)
- Three-drug GDMT
- 33.0% (n = 61)
- No GDMT component prescribed
- Ten per cent (n = 19)
Observational data: associations, not effects.
Further findings
| Outcome | Odds of survival (CI) | P value |
|---|---|---|
| Survival with ≥1 additional GDMT class added during admission vs none · 6 months and 1 year≥1 GDMT class added vs No GDMT added · 6 month survival | 7.1 (1.9–28.5) | P < 0.01 |
| Survival with ≥1 additional GDMT class added during admission vs none · 6 months and 1 year≥1 GDMT class added vs No GDMT added · 1 year survival | 6.0 (1.9–20.5) | P < 0.01 |
Predictors of GDMT addition (multivariable logistic regression adjusted for baseline GDMT)
- Lower left ventricular ejection fraction (LVEF) and transfer from an outside hospital associated with GDMT addition
- P < 0.05
Length of hospital stay
- Median length of stay 12 days
- IQR 7, 18
Original publication
Guideline-Directed Medical Therapy Implementation During Hospitalization for Cardiogenic Shock. ESC Heart Fail. Published 26 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →