The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection Fraction

There are gaps in the use of therapies that save lives and improve quality of life for patients with heart failure with reduced ejection fraction, both in the US and abroad. The evidence is clear that initiation and titration of guideline-directed medical therapy (GDMT) and comprehensive disease-mod...

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Main Authors: Nicholas K Brownell, Boback Ziaeian, Gregg C Fonarow
Format: Article
Language:English
Published: Radcliffe Medical Media 2021-11-01
Series:Cardiac Failure Review
Online Access:https://www.cfrjournal.com/articleindex/cfr.2021.18
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author Nicholas K Brownell
Boback Ziaeian
Gregg C Fonarow
author_facet Nicholas K Brownell
Boback Ziaeian
Gregg C Fonarow
author_sort Nicholas K Brownell
collection DOAJ
description There are gaps in the use of therapies that save lives and improve quality of life for patients with heart failure with reduced ejection fraction, both in the US and abroad. The evidence is clear that initiation and titration of guideline-directed medical therapy (GDMT) and comprehensive disease-modifying medical therapy (CDMMT) to maximally tolerated doses improves patient-focused outcomes, yet observational data suggest this does not happen. The purpose of this review is to describe the gap in the use of optimal treatment worldwide and discuss the benefits of newer heart failure therapies including angiotensin receptor-neprilysin inhibitors and sodium-glucose cotransporter 2 inhibitors. It will also cover the efficacy and safety of such treatments and provide potential pathways for the initiation and rapid titration of GDMT/CDMMT.
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series Cardiac Failure Review
spelling doaj-art-7df8f12bd1b04596939dc345b61dda0f2024-12-14T16:03:10ZengRadcliffe Medical MediaCardiac Failure Review2057-75402057-75592021-11-01710.15420/cfr.2021.18The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection FractionNicholas K Brownell0Boback Ziaeian1Gregg C Fonarow2Division of Cardiology, University of California Los Angeles (UCLA), Los Angeles, CA, USDivision of Cardiology, University of California Los Angeles (UCLA), Los Angeles, CA, USDivision of Cardiology, University of California Los Angeles (UCLA), Los Angeles, CA, US; Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center, Los Angeles, CA, USThere are gaps in the use of therapies that save lives and improve quality of life for patients with heart failure with reduced ejection fraction, both in the US and abroad. The evidence is clear that initiation and titration of guideline-directed medical therapy (GDMT) and comprehensive disease-modifying medical therapy (CDMMT) to maximally tolerated doses improves patient-focused outcomes, yet observational data suggest this does not happen. The purpose of this review is to describe the gap in the use of optimal treatment worldwide and discuss the benefits of newer heart failure therapies including angiotensin receptor-neprilysin inhibitors and sodium-glucose cotransporter 2 inhibitors. It will also cover the efficacy and safety of such treatments and provide potential pathways for the initiation and rapid titration of GDMT/CDMMT.https://www.cfrjournal.com/articleindex/cfr.2021.18
spellingShingle Nicholas K Brownell
Boback Ziaeian
Gregg C Fonarow
The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection Fraction
Cardiac Failure Review
title The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection Fraction
title_full The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection Fraction
title_fullStr The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection Fraction
title_full_unstemmed The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection Fraction
title_short The Gap to Fill: Rationale for Rapid Initiation and Optimal Titration of Comprehensive Disease-modifying Medical Therapy for Heart Failure with Reduced Ejection Fraction
title_sort gap to fill rationale for rapid initiation and optimal titration of comprehensive disease modifying medical therapy for heart failure with reduced ejection fraction
url https://www.cfrjournal.com/articleindex/cfr.2021.18
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