Heart failure & cardiomyopathies
Inpatient Use of Guideline-Directed Medical Therapy During Heart Failure Hospitalizations Among Community-Based Health Systems
Authors' conclusion
Inpatient GDMT use in a national analysis of HF hospitalizations was lower than reported in quality improvement registries.
Study context
- Population
- Heart failure with reduced ejection fraction (HFrEF) patients hospitalised for heart failure (HF) at US community-based health systems, 2016–202213,729 HFrEF patients
- Participants
- 20,387 HF hospitalizations
- Outcome
- In-hospital and discharge rates of GDMT use
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Inpatient GDMT use (% of eligible hospitalisations)
- RAS inhibitors
- 70%
- Beta-blockers
- 86%
- MRA
- 37%
- ARNI
- 17%
- SGLT2 inhibitors
- 8%
- Triple/quadruple therapy, inpatient
- 26%
- Triple/quadruple therapy, discharge
- 14%
Observational data: associations, not effects.
Further findings
Predischarge guideline-directed medical therapy (GDMT) discontinuation
- No medical contraindications
- 43%-57%
- Associated with inpatient hypotension, hyperkalemia and worsening renal function
90-day all-cause death and HF readmission, ≥3 GDMT classes vs less comprehensive GDMT
- ≥3 GDMT classes associated with fewer 90-day all-cause deaths and HF readmissions (adjusted)
- Adjusted analyses
Original publication
Inpatient Use of Guideline-Directed Medical Therapy During Heart Failure Hospitalizations Among Community-Based Health Systems. JACC Heart Fail. Published 11 September 2024. doi:10.
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