Heart failure & cardiomyopathies
One-Year Outcomes in Patients Hospitalized for Heart Failure With Reduced Ejection Fraction Prescribed Quadruple Medical Therapy at Discharge
Authors' conclusion
In this nationwide cohort study, even when prescribed quadruple medical therapy, older patients hospitalized for HFrEF in US clinical practice face substantial residual risk of death and HF readmission and often accrue high health care costs.
Study context
- Population
- Medicare beneficiaries hospitalized for heart failure with reduced ejection fraction (HFrEF) in the Get With The Guidelines-Heart Failure registry, discharged from US hospitals July 2021–December 2023
- Participants
- 20,651 beneficiaries532 US hospitals
- Outcome
- Mortality, HF hospitalization, mortality or HF hospitalization, and per-patient health care expenditure (Medicare Part A and B costs, 2023 US dollars)
- Follow-up
- 12 months
Methodological detailsregistry-based, nationwide
- Registry-based
- Nationwide
Main finding
As reported in the abstract
| Group | All-cause mortality (cumulative incidence) | HF hospitalization (cumulative incidence) | All-cause mortality or HF hospitalization (cumulative incidence) | Per-patient health care expenditure, median (IQR) |
|---|---|---|---|---|
| Quadruple therapy | 19.3% (95% CI, 17.3%-21.4%) | 26.0% (95% CI, 23.6%-28.5%) | 37.1% (95% CI, 34.4%-39.8%) | $27 956 ($7478-$61 126) |
Quadruple therapy
All-cause mortality (cumulative incidence)19.3% (95% CI, 17.3%-21.4%)
HF hospitalization (cumulative incidence)26.0% (95% CI, 23.6%-28.5%)
All-cause mortality or HF hospitalization (cumulative incidence)37.1% (95% CI, 34.4%-39.8%)
Per-patient health care expenditure, median (IQR)$27 956 ($7478-$61 126)
Observational data: associations, not effects.
Further findings
Prescription of quadruple therapy at discharge
- Prescribed quadruple therapy
- 1490 (7.2%)
- Between-hospital variance, median OR
- 2.04 (1.89-2.24) (95% CI)
12-month mortality and HF hospitalization, first vs second half of study period
- Similar in the first half vs the second half of the study period
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
One-Year Outcomes in Patients Hospitalized for Heart Failure With Reduced Ejection Fraction Prescribed Quadruple Medical Therapy at Discharge. JAMA Cardiol. Published 1 March 2026. doi:10. 1001/ jamacardio. 2025. 5339
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