Heart failure & cardiomyopathies
Polypharmacy and Guideline-Directed Medical Therapy Initiation Among Adults Hospitalized With Heart Failure
Authors' conclusion
Polypharmacy is an important barrier to GDMT.
Study context
- Population
- Adults hospitalized for HFrEF or heart failure (HF) with mildly reduced EF, 2003–2017, REGARDS study
- Participants
- 545 adults
- Exposure
- Admission medication count 5 to 9 or ≥10 vs 0 to 4
- Outcome
- Initiation of eligible indicated GDMT
Methodological detailsmultivariable Poisson regression
- Multivariable Poisson regression
Main finding
As reported in the abstract
Initiation of ≥1 indicated medication
Each group vs 0 to 4Relative risk (95% CI)P value
5 to 9
0.67(0.56–0.82)
P < 0.001≥10
0.50(0.39–0.64)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Initiation of ≥half of indicated medications5 to 9vs 0 to 4 | 0.64 (0.51–0.81) | P < 0.001 | |
| Initiation of ≥half of indicated medications≥10vs 0 to 4 | 0.50 (0.38–0.67) | P < 0.001 | |
| 0.20.5125Relative risk (log scale) |
Guideline-directed medical therapy (GDMT) not taken at admission
- Not taking beta-blocker
- 34%
- Not taking ACEi/ARB/ARNI or hydralazine-isosorbide dinitrate
- 39%
- Not taking MRA
- 90%
- CAD: not taking antiplatelet agent
- 36%
- CAD: not taking statin
- 38%
- AF: not taking anticoagulant
- 49%
Original publication
Polypharmacy and Guideline-Directed Medical Therapy Initiation Among Adults Hospitalized With Heart Failure. JACC Adv. Published 5 August 2024. doi:10.
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