Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization
Heart failure remains a huge societal concern despite medical advancement, with an annual direct cost of over $30 billion. While guideline-directed medical therapy (GDMT) is proven to reduce morbidity and mortality, many eligible patients with heart failure with reduced ejection fraction (HFrEF) are...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2021-04-01
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| Series: | US Cardiology Review |
| Online Access: | https://www.uscjournal.com/articleindex/usc.2020.29 |
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| _version_ | 1846122495230345216 |
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| author | Neal M Dixit Shivani Shah Boback Ziaeian Gregg C Fonarow Jeffrey J Hsu |
| author_facet | Neal M Dixit Shivani Shah Boback Ziaeian Gregg C Fonarow Jeffrey J Hsu |
| author_sort | Neal M Dixit |
| collection | DOAJ |
| description | Heart failure remains a huge societal concern despite medical advancement, with an annual direct cost of over $30 billion. While guideline-directed medical therapy (GDMT) is proven to reduce morbidity and mortality, many eligible patients with heart failure with reduced ejection fraction (HFrEF) are not receiving one or more of the recommended medications, often due to suboptimal initiation and titration in the outpatient setting. Hospitalization serves as a key point to initiate and titrate GDMT. Four evidence-based therapies have clinical benefit within 30 days of initiation and form a crucial foundation for HFrEF therapy: renin-angiotensin-aldosterone system inhibitors with or without a neprilysin inhibitor, β-blockers, mineralocorticoid-receptor-antagonists, and sodium-glucose cotransporter-2 inhibitors. The authors present a practical guide for the implementation of these four pillars of GDMT during a hospitalization for acute heart failure. |
| format | Article |
| id | doaj-art-ca54115097ca404abb834a9b50fca39c |
| institution | Kabale University |
| issn | 1758-3896 1758-390X |
| language | English |
| publishDate | 2021-04-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | US Cardiology Review |
| spelling | doaj-art-ca54115097ca404abb834a9b50fca39c2024-12-14T16:02:42ZengRadcliffe Medical MediaUS Cardiology Review1758-38961758-390X2021-04-011510.15420/usc.2020.29Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During HospitalizationNeal M Dixit0Shivani Shah1Boback Ziaeian2Gregg C Fonarow3Jeffrey J Hsu4Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Cardiology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CADepartment of Pharmacy Services, Olive View-UCLA Medical Center, Los Angeles, CADepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Cardiology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CADepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Cardiology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CADepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Division of Cardiology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CAHeart failure remains a huge societal concern despite medical advancement, with an annual direct cost of over $30 billion. While guideline-directed medical therapy (GDMT) is proven to reduce morbidity and mortality, many eligible patients with heart failure with reduced ejection fraction (HFrEF) are not receiving one or more of the recommended medications, often due to suboptimal initiation and titration in the outpatient setting. Hospitalization serves as a key point to initiate and titrate GDMT. Four evidence-based therapies have clinical benefit within 30 days of initiation and form a crucial foundation for HFrEF therapy: renin-angiotensin-aldosterone system inhibitors with or without a neprilysin inhibitor, β-blockers, mineralocorticoid-receptor-antagonists, and sodium-glucose cotransporter-2 inhibitors. The authors present a practical guide for the implementation of these four pillars of GDMT during a hospitalization for acute heart failure.https://www.uscjournal.com/articleindex/usc.2020.29 |
| spellingShingle | Neal M Dixit Shivani Shah Boback Ziaeian Gregg C Fonarow Jeffrey J Hsu Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization US Cardiology Review |
| title | Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization |
| title_full | Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization |
| title_fullStr | Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization |
| title_full_unstemmed | Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization |
| title_short | Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization |
| title_sort | optimizing guideline directed medical therapies for heart failure with reduced ejection fraction during hospitalization |
| url | https://www.uscjournal.com/articleindex/usc.2020.29 |
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