Heart failure & cardiomyopathiesCohort study
Newly diagnosed heart failure with reduced ejection fraction: timing, sequencing, and titration of guideline-recommended medical therapy
- Prospective registry study
- multicentre
- 48 Dutch hospitals
- ongoing
Authors' conclusion
The TITRATE-HF study demonstrates that rapid initiation of GRMT for HFrEF is feasible in real-world clinical practice.
Study context
- Population
- De novo HFrEF patients in the TITRATE-HF registry, 48 Dutch hospitals
- Participants
- 1,508 patients
- Outcome
- Feasibility of rapid Guideline-recommended medical therapy (GRMT) implementation: titration patterns and barriers
- Follow-up
- From diagnosis to 6 months
Main finding
As reported in the abstract
- Using quadruple therapy at 6 weeks
- 46%
- Prescribed quadruple therapy at some point within 6 weeks of diagnosis
- 50%
- Of these, remaining on quadruple therapy after 180 days
- 84%
- Prescribed quadruple therapy at 6 months
- 66.3%
- Target doses of all four drug classes at 6 months
- 1.3%
- Side effects as reason target doses not reached
- 20%-37%
Observational data: associations, not effects.
Further findings
Rechallenge after discontinuation
- Rechallenge successful
- over 83%
Safety
Discontinuation, primarily due to side effects or intolerances
- ACEi
- 13%
- ARB
- 11%
- ARNI
- 9%
- Beta-blocker
- 9%
- MRA
- 11%
- SGLT2 inhibitors
- 9%
Original publication
Newly diagnosed heart failure with reduced ejection fraction: timing, sequencing, and titration of guideline-recommended medical therapy. Eur Heart J. Published 24 April 2025. doi:10.1093/eurheartj/ehaf244
Summarised from the published abstract; every number is checked against it