Heart failure & cardiomyopathies
Improvements in Medical Therapy and Prognosis for Patients with HFrEF Following the 2021 ESC Heart Failure (HF) Guidelines
Authors' conclusion
The utilisation of GDMT in Norwegian HF clinics has increased markedly since 2016, with a fourfold acceleration in MRA and a substantial increase in SGLT2i use following the 2021 ESC HF guidelines. HF hospitalisations have consistently declined, while mortality rates first declined after 2021.
Study context
- Population
- Patients with HFrEF (LVEF ≤40%) treated at HF outpatient clinics, Norwegian HF Registry, 2016–2023
- Participants
- 13,992 patients
- Outcome
- Temporal trends in guideline-directed medical therapy (GDMT) use and prognosis (HF hospitalisations, mortality)
Methodological detailsnational registry, temporal trends
- National registry
- Temporal trends
Main finding
As reported in the abstract
GDMT utilisation over time
- Beta-blockers and RAS inhibitors since 2016
- >90%
- Angiotensin receptor-neprilysin inhibitors (ARNI) utilisation, 2016 to 2023
- 4% to 54%
- Mineralocorticoid-receptor-antagonists (MRA) utilisation, 2016 to 2021 (+3% per year)
- 36% to 54%
- MRA utilisation, 2021 to 2023 (+12% per year)
- 54% to 78%
- SGLT2 inhibitor utilisation, 2020 to 2023
- 3% to 85%
Observational data: associations, not effects.
Further findings
Crude 6-month mortality
- 2016–2021
- 2.7%
- Decline of ≈0.5% per year to 2023
- 1.8%
HF hospitalisations
- 2016 to 2021
- 12.9% to 8.2%
- 2023
- 6.8%
Original publication
Improvements in Medical Therapy and Prognosis for Patients with HFrEF Following the 2021 ESC HF Guidelines. ESC Heart Fail. Published 27 June 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →