Heart failure & cardiomyopathies
Prescription of Guideline-Directed Medical Therapy in Heart Failure: Impact on Mortality and Readmission
Authors' conclusion
Our study suggests that the newly recommended four-drug therapy may lead to lower mortality and readmission rates compared to the outdated two-drug therapy. However, the overall adoption of the four-drug therapy remains limited.
Study context
- Population
- Patients insured at Germany's largest health insurer (AOK) with a claims record for hospitalization (2019–2021) with the main diagnosis of heart failure (HF)cases of hospitalization due to HF (median 80 years [IQR 72–86], 53.7% female)
- Participants
- 315,342 patients
- Comparison
- Four- versus two-drug treatment
- Outcome
- HF drug prescription rates
Methodological detailsGermany's largest health insurer (AOK), 2019-2021
- Germany's largest health insurer (AOK)
- 2019-2021
Main finding
As reported in the abstract
- ACEI
- 46.3%
- ARB
- 31.8%
- ARNI
- 12.1%
- Beta-blocker (BB)
- 80.9%
- MRA
- 35.6%
- SGLT2i
- 7.3%
Further findings
Treatment combinations prescribed
Kaplan-Meier survival
| Outcome | Four-drug | Two-drug | Estimate | |
|---|---|---|---|---|
| MortalityMortality risk significantly lower | 88.2% (95% CI 87.6%–88.8%) | 83.1% (95% CI 82.9%–83.3%) | adjusted HR 0.92 (95% CI 0.86–0.97) | |
| Readmission due to all causes | HR 0.76 (CI 0.73–0.80) | |||
| Readmission due to HF | HR 0.90 (CI 0.85–0.95) | |||
| 0.512Ratio (log scale) |
Total mortality, all-cause readmission, HF readmission (overall) · within 91-365 days following the index stay
- Total mortality
- 18.0%
- All-cause readmission
- 32.0%
- HF readmission
- 16.0%
Original publication
Prescription of Guideline-Directed Medical Therapy in Heart Failure: Impact on Mortality and Readmission. ESC Heart Fail. Published 29 April 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →