Heart failure & cardiomyopathiesResearch article
National Impact of Optimal Implementation of Guideline-Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction
- Decision analytic modelling study
- population-level
- sensitivity analyses using alternative treatment-rate sources
Authors' conclusion
Incomplete implementation of quadruple GDMT in HFrEF remains a major modifiable opportunity to reduce preventable deaths and HF hospitalizations in the United States.
Study context
- Population
- US adults with chronic symptomatic heart failure with reduced ejection fraction (HFrEF) eligible for quadruple guideline-directed medical therapy (GDMT)2.76 million eligible adults (modelled)
- Participants
- 733,891 / 1,856,531 / 1,543,967 / 1,717,444
- Comparison
- Optimal implementation of quadruple GDMT vs current treatment rates
- Beta-blockersn = 733,891
- Angiotensin receptor-neprilysin inhibitors (ARNIs)n = 1,856,531
- Mineralocorticoid receptor antagonists (MRAs)n = 1,543,967
- SGLT2 inhibitorsn = 1,717,444
- Outcome
- Deaths preventable and annual HF hospitalizations prevented with optimal implementation of quadruple GDMT
- Follow-up
- 12 months
Main finding
As reported in the abstract
Projected deaths preventable · over 12 months
Beta-blockers
26,210
events
ARNIs
34,495
events
MRAs
26,620
events
SGLT2 inhibitors
26,422
events
- Aggregate deaths preventable across treatment gaps
- 113,747 (95% UI 90,173-149,875)
- Heart failure (HF) hospitalizations prevented annually
- 357,332 (95% UI 297,493-425,674)
Further findings
Receipt of quadruple GDMT among eligible
- Received quadruple GDMT
- 18.2%
Original publication
National Impact of Optimal Implementation of Guideline-Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction. JACC Heart Fail. Published 2 August 2026. doi:10.1016/j.jchf.2026.103295
Summarised from the published abstract; every number is checked against it