Table 1.
Guideline-based therapy application in females with HFrEF
| Specific differences in benefits between sexes | Likelihood of getting evidence-based treatment | Dose adjustment required | |
|---|---|---|---|
| Diagnostic pathway | |||
| BNP | No [3] | - | - |
| TTE | No [22] | - | - |
| Pharmacotherapy | |||
| ACEI/ARB | No [11] | - | Yes [38] |
| Betablocker | No [5] | Under prescribed [5] | Yes [5] |
| Digoxin | No [11] | - | Yes [11] |
| Diuretics | - | Under prescribed [6] | - |
| Anticoagulants | − | Under prescribed [6] | - |
| ARNI | No [36] | Under prescribed [35] | - |
| Device therapy | |||
| ICD | No [5] | Underused [6] | - |
| CRT | Women more likely to respond [11] | More than male equivalent [11] | - |
| Cardiac rehab | No [11] | Under enrolled [11] | - |
BNP B-type natriuretic peptide, TTE transthoracic echocardiogram, ACEI angiotensin-converting enzyme inhibitors, ARB angiotensin II receptor blockers, ARNI angiotensin receptor neprilysin inhibitor, ICD implantable cardioverter-defibrillator, CRT cardiac resynchronization therapy, HFrEF heart failure reduced ejection fraction.