Heart failure & cardiomyopathiesSecondary analysis
Polypharmacy and Optimization of Guideline-Directed Medical Therapy in Heart Failure
- Secondary analysis of the GUIDE-IT randomised trial
- post hoc analysis
Authors' conclusion
Patients with HFrEF who are on non-GDMT polypharmacy have lower odds of achieving optimal GDMT on follow-up.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) in the GUIDE-IT trial
- Participants
- 891 patients
- Comparison
- Polypharmacy vs no polypharmacy at baseline
- Polypharmacyn = 414
- Primary endpoint
- Optimal triple therapy GDMT (RAAS blocker and beta-blocker at 50% of target dose plus MRA at any dose)
- Follow-up
- 12-month follow-up
Primary result
As reported in the abstract
Odds of achieving optimal GDMT over time
Odds ratio (95% CI)P value
No polypharmacy
1.16(1.12–1.21)
P < 0.001Polypharmacy
1.01(0.96–1.06)
Per 1-month increase, as printed
Further findings
Non-GDMT medications at baseline
- Median number of non-GDMT medications
- 4 (IQR: 3-6)
Original publication
Polypharmacy and Optimization of Guideline-Directed Medical Therapy in Heart Failure. JACC Heart Fail. Published 26 April 2023. doi:10.1016/j.jchf.2023.03.007
Summarised from the published abstract; every number is checked against it