The top panel presents the proportion of all patients either initiated or continued on GDMT by discharge. The bottom panel presents the proportion of patients who had GDMT discontinued or reduced in dose without having other GDMT classes initiated in place of these changes. Abbreviations: ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin receptor blockers; ARNI, angiotensin receptor-neprilysin inhibitors; GDMT, guideline-directed medical therapy; MRA, mineralocorticoid receptor antagonists; SGLT2i, sodium-glucose cotransporter-2 inhibitors.