Table 15.
Current Use of Guideline Directed Medical Therapy
| GDMT | ||||||||
|---|---|---|---|---|---|---|---|---|
| ACE/ARB/ARNi | ARNi | ACEi/ARB | ACEi | ARB | Beta Blocker | MRA | SGLT2i | |
| Percentage of Patients on Treatment | ||||||||
| EVOLUTION-HF 2023 | 73% | 55% | 62% | 75% | 58% | 77% | ||
| CHAMP-HF 2018 | 72% | 13% | 60% | 67% | 33% | |||
| PINNACLE 2020 | 78% | 9% | 55% | 28% | 75% | |||
| QUALIFY 2016 | 66% | 22% | 87% | 69% | ||||
| ESC-HF 2013 | 92% | 71% | 24% | 93% | 67% | |||
| BIOSTAT-CHF 2017 | 85% | 90% | ||||||
| Savarese et al. 2021 | 73% | 45% | 67% | 76% | 60% | |||
| Percentage of Patients at ≥ 50% of Target Doses | ||||||||
| EVOLUTION-HF 2023 | 27% | 18% | 9% | 24% | 53% | |||
| CHAMP-HF 2017 | 40% | 44% | 40% | 54% | 98% | |||
| BIOSTAT-CHF 2017 | 53% | 40% | ||||||
| QUALIFY 2016 | 63% | 40% | 52% | 99% | ||||
| Savarese et al. 2021 | 53% | 28% | 19% | 30% | 60% | |||
| Percentage of Patients on Target Doses of GDMT | ||||||||
| EVOLUTION-HF 2023 | 28% | 20% | 7% | 7% | 5% | 76% | ||
| CHAMP-HF 2017 | 17% | 14% | 18% | 28% | 77% | |||
| QUALIFY 2016 | 28% | 7% | 15% | 71% | ||||
| ESC-HF 2013 | 29% | 24% | 18% | 31% | ||||
| BIOSTAT-CHF 2017 | 22% | 27% | 20% | 12% | ||||
| Savarese etal. 2021 | 30% | 15% | 10% | 12% | 60% | |||
ACEi = angiotensin-converting enzyme inhibitor; ARB = angiotensin receptor blocker; ARNi = angiotensin receptor - neprilysin inhibitor; BIOSTAT CHF = A Systems Biology Study to Tailored Treatment in Chronic Heart Failure; CHAMP HF = Change the Management of Patients with Heart Failure; ESC - HF = European Society of Cardiology. Heart Failure; EVOLUTION HF = Utilization of Dapagliflozin and Other Guideline Directed Medical Therapies in Heart Failure Patients: A Multinational Observational Study Based on Secondary Data; MRA = mineralocorticoid receptor antagonists; PINNICLE HF = Practice Innovation and Clinical Excellence Registry; QUALIFY = Quality of Adherence to Guideline Recommendations for Life-Saving Treatment in Heart Failure Survey; SGLT2i = Sodium-Glucose Cotransporter 2 Inhibitors
Savarese G, Kishi T, Vardeny 0, Adamsson Eryd S, Bodegard J, Lund LH, et al. Heart Failure Drug Treatment-lnertia,Titration, and Discontinuation: A Multinational Observational Study (EVOLUTION HF). JACC Heart Fail. 2023 Jan;11(1):1–14.
Brownell NK, Ziaeian B, Fonarow GC. The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection Fraction. Card Fail Rev. 2021 Mar;7:e18.