A scoring evaluation for the practical introduction of guideline‐directed medical therapy in heart failure patients

Aims The guideline‐directed medical therapy (GDMT) has been recommended for heart failure (HF) with reduced ejection fraction (HFrEF) based on the accumulating clinical evidence. However, it is difficult to implement all the trial‐proven medications for every patient in the real world. Methods and r...

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Bibliographic Details
Published in:ESC Heart Failure 2023-12, Vol.10 (6), p.3352-3363
Main Authors: Matsukawa, Ryuichi, Okahara, Arihide, Tokutome, Masaki, Itonaga, Junpei, Koga, Eiichi, Hara, Ayano, Kisanuki, Hiroshi, Sada, Masashi, Okabe, Kousuke, Kawai, Shunsuke, Ogawa, Kiyohiro, Matsuura, Hirohide, Mukai, Yasushi
Format: Article
Language:English
Subjects:
Beta blockers
Blood pressure
Body mass index
Chronic obstructive pulmonary disease
Clinical outcomes
Consortia
Drug dosages
Ejection fraction
Enzymes
Glucose
Heart failure
Original
Patients
Prognosis
Regression analysis
Simple GDMT score
Sodium
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Summary:Aims The guideline‐directed medical therapy (GDMT) has been recommended for heart failure (HF) with reduced ejection fraction (HFrEF) based on the accumulating clinical evidence. However, it is difficult to implement all the trial‐proven medications for every patient in the real world. Methods and results A simple GDMT score was created, according to the combination of GDMT drugs (renin–angiotensin system inhibitors, beta‐blockers, mineralocorticoid receptor antagonists, and sodium–glucose transporter 2 inhibitors) administration and their dosage (0–9 points). Its impact on the prognosis of HF patients was investigated. Admitted HF patients [HFrEF and HF with mildly reduced ejection fraction (HFmrEF), n = 1054] were retrospectively analysed (excluding those with in‐hospital death and dialysis). A simple GDMT score ≥5, but not the number of medications, was significantly associated with a reduction of all‐cause death, HF readmission, and composite outcome (HF readmission and all‐cause death) (P 
ISSN:2055-5822
2055-5822
DOI:10.1002/ehf2.14524