Heart failure & cardiomyopathiesCohort study
Medical treatments at 6 months in hospitalized and ambulatory heart failure with reduced ejection fraction (HFrEF) patients in the BRING-UP 3 Heart Failure study
- observational, prospective, nationwide investigation
- 179 sites
Authors' conclusion
In this large nationwide cohort, guideline-directed therapies for HFrEF were widely implemented and maintained over 6 months with excellent treatment persistence. However, dose optimization remains a key unmet need in routine clinical practice.
Study context
- Population
- HFrEF patients enrolled in the ambulatory and hospitalized cohorts with complete pharmacological data at 6-month follow-upHFrEF patients enrolled, 142 (4.4%) had died by 6 months, treatment data available for 2950 patients
- Participants
- 3,201 patients
- Exposure
- ambulatory vs hospitalized
Main finding
As reported in the abstract
Quadruple therapy at 6 months
64.3%
Quadruple therapy at baseline/discharge
63.9%
Observational data: associations, not effects.
Further findings
Quadruple therapy including ARNI · baseline/discharge to 6 months
- Quadruple therapy including ARNI went from
- 52.9%
- to
- 55.9%
- P < .0001
Deaths by 6 months
- Died by 6 months
- 142 (4.4%)
Baseline characteristics
- Mean age
- 69 ± 11 years
- > 75 years
- 26.6%
- Female
- 18.0%
Guideline-directed medical therapy (GDMT) prescription rates · 6 months
- Prescription rates of GDMT were high at baseline and remained stable over 6-months, with a shift from ACE-I/ARBs to ARNIs, and a modest increase in SGLT2i use
- A significant reduction in diuretic prescription
Dose up-titration and discontinuation · follow-up
- Dose up-titration of GDMT remained suboptimal, with most agents prescribed at <50% of target doses
- Discontinuation rates at follow-up were very low
Original publication
Summarised from the published abstract; every number is checked against it