Key result
Guideline-directed medical therapy utilization was suboptimal, with only 38.7% of heart failure patients receiving the triple regimen of ACEIs/ARBs, MRAs, and β-blockers.
Why the study?
To assess the characteristics of patients with HFrEF and HFmrEF, as well as the current application of GDMT in Palestine.
What is the rate of guideline-directed medical therapy prescription and optimization in patients with HFrEF and HFmrEF in Palestine?
Cohort
Yes
What is the rate of guideline-directed medical therapy prescription and optimization in patients with HFrEF and HFmrEF in Palestine?
Less than half of heart failure patients in this Palestinian cohort received triple guideline-directed medical therapy, with age, diabetes, chronic renal disease, and prior HF admission associated with reduced utilization.
Signals need for local HF therapy audits in Palestine; leaves open whether addressing barriers improves triple GDMT rates.
To assess the characteristics of patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with mid-range ejection fraction (HFmrEF), as well as the current application of guideline-directed medical therapy (GDMT) in Palestine. This retrospective cohort study involved a population of heart failure (HF) patients who visited cardiology clinics at An-Najah National University Hospital and the National Hospital, Palestine. The primary outcome measures of interest were the proportions of patients prescribed guideline-based cardiovascular medications (GBCMs), such as angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), β-blockers, and mineralocorticoid receptor antagonists (MRAs), and the corresponding optimized doses at ≥ 50 % of targets and the reasons underlying the non-prescription of GDMT. A total of 70.5%, 56.6%, and 88.6% of patients were on ACEIs/ARBs, MRAs, and β-blockers, respectively. Of all patients, 38.7% were on the triple GDMT regimen. Less than half the patients received the triple combination treatment. Age, diabetes mellitus, chronic renal disease, and admission to the hospital for HF all had significant independent relationships with the reduced utilization and inadequate dosage of GDMT.
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Jairoun et al. (2024) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) and mid-range ejection fraction (HFmrEF). Guideline-directed medical therapy (GDMT) was evaluated on Proportions of patients prescribed guideline-based cardiovascular medications (ACEIs/ARBs, β-blockers, MRAs) and optimized doses at ≥ 50% of targets. Guideline-directed medical therapy utilization was suboptimal, with only 38.7% of heart failure patients receiving the triple regimen of ACEIs/ARBs, MRAs, and β-blockers.
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