| Title: |
Prevalence and clinical significance of guideline-directed medical therapy in acute heart failure with reduced or mildly reduced ejection fraction |
| Authors: |
Miyoshi, Yutaro; Kato, Takao; Morimoto, Takeshi; Ozasa, Neiko; Yaku, Hidenori; Inuzuka, Yasutaka; Tamaki, Yodo; Yamamoto, Erika; Yoshikawa, Yusuke; Kitai, Takeshi; Iguchi, Moritake; Nagao, Kazuya; Kawase, Yuichi; Morinaga, Takashi; Furukawa, Yutaka; Ando, Kenji; Sato, Yukihito; Kuwahara, Koichiro; Ono, Koh; Kimura, Takeshi |
| Contributors: |
三好, 悠太郎; 加藤, 貴雄; 小笹, 寧子; 山本, 絵里香; 芳川, 裕亮; 尾野, 亘; 木村, 剛; 91030831; 30583877; 30467485; 30837670; 00359275; 80359786 |
| Publisher Information: |
Springer Nature |
| Publication Year: |
2026 |
| Collection: |
Kyoto University Research Information Repository (KURENAI) / 京都大学学術情報リポジトリ |
| Subject Terms: |
Heart failure; Guideline-directed medical therapy; Angiotensin-converting enzyme inhibitors; Angiotensin receptor blockers; Beta-blockers; Mineralocorticoid receptor antagonists |
| Description: |
There are limited reports on the prevalence and clinical significance of guideline-directed medical therapy (GDMT) initiation in patients with acute heart failure (HF). We analyzed 2086 patients with acute heart failure with reduced or mildly reduced ejection fraction (HFrEF or HFmrEF) in the KCHF registry. The patients were classified according to the number of GDMT classes at discharge. The primary outcome was a composite of all-cause death or HF hospitalization. There were 181 (8.7%), 508 (24.4%), 791 (37.9%), and 606 (29.1%) patients with GDMT = 0, 1, 2, and 3, respectively. Current smoker, ambulatory status, and HFrEF were associated with full GDMT, whereas age ≥ 80 years old, acute coronary syndrome, anemia, and eGFR < 30 mL/min/1.73m2 were associated with absence of full GDMT. The cumulative 1-year incidence of the primary outcome was 56.3%, 40.7%, 31.9%, and 25.1% with GDMT = 0, 1, 2, and 3, respectively. The excess adjusted risk of patients with GDMT = 0 or 1, but not GDMT = 2 relative to those of GDMT = 3 remained significant for the primary outcome (HR 2.16 [1.66–2.82], 1.33 [1.07–1.66], and 1.03 [0.84–1.27]). Collectively, the greater number of GDMT classes at discharge was associated with a lower risk for all-cause death or HF hospitalization in patients with HFrEF or HFmrEF. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://hdl.handle.net/2433/299972; Scientific Reports; 16; 5116 |
| Availability: |
https://hdl.handle.net/2433/299972 |
| Rights: |
© The Author(s) 2026 ; This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. ; https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: |
edsbas.588ECE2A |
| Database: |
BASE |