In-hospital Initiation and Up-titration of Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction

Implementation of guideline-directed medical therapy for patients with heart failure is suboptimal. The use of guideline-directed medical therapy improves minimally after heart failure hospitalisation, despite this event clearly indicating increased risk of further hospitalisation and death. In-hosp...

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Main Authors: Zachary L Cox, Shuktika Nandkeolyar, Andrew J Johnson, JoAnn Lindenfeld, Aniket S Rali
Format: Article
Language:English
Published: Radcliffe Medical Media 2022-06-01
Series:Cardiac Failure Review
Online Access:https://www.cfrjournal.com/articleindex/cfr.2022.08
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author Zachary L Cox
Shuktika Nandkeolyar
Andrew J Johnson
JoAnn Lindenfeld
Aniket S Rali
author_facet Zachary L Cox
Shuktika Nandkeolyar
Andrew J Johnson
JoAnn Lindenfeld
Aniket S Rali
author_sort Zachary L Cox
collection DOAJ
description Implementation of guideline-directed medical therapy for patients with heart failure is suboptimal. The use of guideline-directed medical therapy improves minimally after heart failure hospitalisation, despite this event clearly indicating increased risk of further hospitalisation and death. In-hospital initiation and titration of guideline-directed medical therapies is one potential strategy to fill these gaps in care, both in the acute vulnerable period after hospital discharge and in the long term. The purpose of this article is to review the knowledge gaps in best practices of in-hospital initiation and up-titration of guideline-directed medical therapies, the benefits and risks of in-hospital initiation and post-discharge focused titration of guideline-directed medical therapies, the recent literature evaluating these practices, and propose strategies to apply these principles to the care of patients with heart failure with reduced ejection fraction.
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publisher Radcliffe Medical Media
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series Cardiac Failure Review
spelling doaj-art-40a0da16631b45fbab87101bbc713b4e2024-12-14T16:03:43ZengRadcliffe Medical MediaCardiac Failure Review2057-75402057-75592022-06-01810.15420/cfr.2022.08In-hospital Initiation and Up-titration of Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection FractionZachary L Cox0Shuktika Nandkeolyar1Andrew J Johnson2JoAnn Lindenfeld3Aniket S Rali4Department of Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, TN, US; Department of Pharmacy, Vanderbilt University Medical Center, Nashville, TN, USDivision of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USDepartment of Pharmacy, Vanderbilt University Medical Center, Nashville, TN, USDivision of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USDivision of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USImplementation of guideline-directed medical therapy for patients with heart failure is suboptimal. The use of guideline-directed medical therapy improves minimally after heart failure hospitalisation, despite this event clearly indicating increased risk of further hospitalisation and death. In-hospital initiation and titration of guideline-directed medical therapies is one potential strategy to fill these gaps in care, both in the acute vulnerable period after hospital discharge and in the long term. The purpose of this article is to review the knowledge gaps in best practices of in-hospital initiation and up-titration of guideline-directed medical therapies, the benefits and risks of in-hospital initiation and post-discharge focused titration of guideline-directed medical therapies, the recent literature evaluating these practices, and propose strategies to apply these principles to the care of patients with heart failure with reduced ejection fraction.https://www.cfrjournal.com/articleindex/cfr.2022.08
spellingShingle Zachary L Cox
Shuktika Nandkeolyar
Andrew J Johnson
JoAnn Lindenfeld
Aniket S Rali
In-hospital Initiation and Up-titration of Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction
Cardiac Failure Review
title In-hospital Initiation and Up-titration of Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction
title_full In-hospital Initiation and Up-titration of Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction
title_fullStr In-hospital Initiation and Up-titration of Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction
title_full_unstemmed In-hospital Initiation and Up-titration of Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction
title_short In-hospital Initiation and Up-titration of Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction
title_sort in hospital initiation and up titration of guideline directed medical therapies for heart failure with reduced ejection fraction
url https://www.cfrjournal.com/articleindex/cfr.2022.08
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