Heart failure & cardiomyopathiesCohort study
Inpatient Use of Guideline-Directed Medical Therapy During Heart Failure Hospitalizations Among Community-Based Health Systems
- Retrospective cohort study
- multicentre
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 patients
- Outcome
- In-hospital and discharge rates of GDMT use
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:10.1016/j.jchf.2024.08.004
Summarised from the published abstract; every number is checked against it