Heart failure & cardiomyopathies
Guideline-Directed Medical Therapy Rates in Heart Failure Patients witH Reduced Ejection Fraction in a Diverse Cohort
Authors' conclusion
Our study using real-world data from a diverse health system demonstrated gaps in GDMT use among patients with HFrEF, specifically older patients with more comorbidities.
Study context
- Population
- Patients with heart failure and left ventricular ejection fraction ≤40% between 2015 and 2021, Kaiser Permanente Mid-Atlantic Statespatients included
- Participants
- 3,154 patients
- Outcome
- GDMT use by medication class
Methodological detailslarge integrated health system
- Large integrated health system
Main finding
As reported in the abstract
- On some form of guideline-directed medical therapy (GDMT)
- 93.8%
- ACEis/angiotensin receptor blockers (ARBs)/angiotensin receptor-neprilysin inhibitors (ARNis) (among those on some form of GDMT)
- 82.8%
- Beta-blockers (BBs) (among those on some form of GDMT)
- 81.4%
- Mineralocorticoid receptor antagonists (MRAs) (among those on some form of GDMT)
- 23.5%
- SGLT2is (among those on some form of GDMT)
- 3.6%
- Vasodilators (Black patients only; among those on some form of GDMT)
- 13.4%
Observational data: associations, not effects.
Further findings
Treated at ≥80% of the target dose, among treated patients
- ACEis/ARBs/ARNis
- 45.8%
- BBs
- 21.4%
- MRAs
- 77.6%
- SGLT2is
- 100%
- Vasodilators
- 14.7%
Predictors of GDMT use
- Increasing age, higher ejection fraction (EF), atrial fibrillation/flutter, chronic obstructive pulmonary disease (COPD), prior stroke and dementia associated with decreased odds of GDMT use
- Higher body mass index (BMI), Black race, higher glomerular filtration rate (GFR), recent echo and cardiac defibrillator associated with increased odds of GDMT use
Predictors of being at ≥80% of the target dose, among treated
- Higher BMI, higher systolic blood pressure, haemoglobin A1C ≥ 6.5% and cardiac defibrillator associated with higher odds
Original publication
Guideline-Directed Medical Therapy Rates in Heart Failure Patients witH Reduced Ejection Fraction in a Diverse Cohort. ESC Heart Fail. Published 19 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →