Target doses for beta-blockers and ACE inhibitors/ARBs/ARNIs were achieved in <20% of heart failure patients, while MRAs reached optimal doses in >90%, with overall high adherence at only 50.6%.
What are the rates of target dose achievement and adherence to guideline-directed medical therapy in patients with chronic heart failure?
Real-world registry data reveals significant gaps in the implementation of guideline-directed medical therapy for heart failure, with low rates of target dose achievement and patient adherence.
Absolute Event Rate: 0% vs 0%
The objective of the study was to evaluate achievement of target doses of essential medications (ACE inhibitors/ARBs/ARNIs, beta-blockers, MRA and SGLT2) and patient adherence to therapy. We analyzed medication prescriptions depending on CHF phenotype and left ventricular ejection fraction (LVEF), as well as dynamics of clinical and laboratory parameters (LVEF and NT-proBNP). There was low rate of achievement of target doses for beta-blockers and ACE inhibitors/ARBs/ARNIs (<20% of patients), while MRAs were prescribed at optimal doses in more than 90% of cases. Only 50.6% of patients demonstrated high adherence to therapy. Repeated assessment of LVEF and NTproBNP was performed in only a subset of patients. However, patients on optimal medical therapy showed improvements of LVEF and decrease of NTproBNP. Therefore, it is necessary to increase physician awareness, improve compliance with clinical guidelines and intensify follow-up to improve treatment adherence and prognosis in patients with CHF.
Airapetyan et al. (Thu,) reported a other. Target doses for beta-blockers and ACE inhibitors/ARBs/ARNIs were achieved in <20% of heart failure patients, while MRAs reached optimal doses in >90%, with overall high adherence at only 50.6%.