Heart failure & cardiomyopathies
Prognostic Significance of Medical Therapy in Patients with Heart Failure with Reduced Ejection Fraction
Authors' conclusion
The real-life SMYRNA study provided comprehensive data about the clinical factors associated with the non-use of GDMT and showed that suboptimal GDMT is associated with an increased risk of hospitalization for HF or cardiovascular death in patients with HFrEF.
Study context
- Population
- Outpatients with HFrEF
- Participants
- 1,062 outpatients
- Exposure
- Triple therapy or 2 classes of heart failure (HF) medications vs ≤1 class of HF medication
- Triple therapyn = 491
- Two classesn = 353
- ≤1 classn = 218reference
- Outcome
- Composite of:
- Hospitalization for HF
- CV death
- Follow-up
- Median 24 months
Methodological detailsmulticentre, observational, real-life setting
- Multicentre
- Observational
- Real-life setting
Main finding
As reported in the abstract
Hospitalization for HF or CV death
Each group vs ≤1 classHazard ratio (95% CI)P value
Two classes
0.65(0.49–0.85)
P = 0.002Triple therapy
0.61(0.47–0.79)
P < 0.001- Primary composite endpoint, overall
- 362 patients (34.1%)
Observational data: associations, not effects.
Further findings
All-cause death, overall · median 24 months
- Patients died
- 177 of 1062 (16.7%)
Prescription of guideline-directed medical therapy (GDMT) classes · enrolment
- Renin-angiotensin system (RAS) inhibitors prescribed
- 76.0%
- Beta-blockers prescribed
- 89.4%
- Mineralocorticoid receptor antagonists (MRAs) prescribed
- 55.1%
- Target dose RAS inhibitors
- 24.4%
- Target dose beta-blockers
- 11.0%
- Target dose MRAs
- 11.1%
Factors independently associated with use or non-use of GDMT
- Older age, NYHA functional class, rural living, hypertension, history of MI
Original publication
Prognostic Significance of Medical Therapy in Patients with Heart Failure with Reduced Ejection Fraction. ESC Heart Fail. Published 7 October 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →