Heart failure medication treatment and prognosis: a retrospective cross-sectional study
ObjectiveHeart failure (HF) is a significant global public health concern and the leading cause of morbidity and mortality worldwide, imposing a substantial economic burden on society. Guideline-directed medical therapy (GDMT) refers to the standardized pharmacological treatment for specific disease...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1532123/full |
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| author | Qiankai Lin Zongjie Lv Daiyi Li Qiao Ling Sha Qiu Xiaomei Lei Fang Qin Na Wang |
| author_facet | Qiankai Lin Zongjie Lv Daiyi Li Qiao Ling Sha Qiu Xiaomei Lei Fang Qin Na Wang |
| author_sort | Qiankai Lin |
| collection | DOAJ |
| description | ObjectiveHeart failure (HF) is a significant global public health concern and the leading cause of morbidity and mortality worldwide, imposing a substantial economic burden on society. Guideline-directed medical therapy (GDMT) refers to the standardized pharmacological treatment for specific diseases based on recommendations from authoritative clinical guidelines and evidence from large-scale randomized clinical trials. GDMT serves as the cornerstone of drug therapy for heart failure patients. This study describes hospitalized HF patients and focuses on drug prescription and readmission rates.MethodsThis study is a retrospective cross-sectional study with data from HF patients obtained from the Second Affiliated Hospital of Chongqing Medical University between January 2016 and June 2021. Patients were considered to have received GDMT if they were prescribed any guideline-recommended medication. Multilevel logistic regression was used to obtain the relationship between medication and readmission rates. The odds ratios (ORs) and 95% confidence intervals (CIs) have been reported.ResultsIn this study, a total of 5,356 HF patients (51.0% female; average age 77 years) were included. Among these patients, the most commonly used medications were mineralocorticoid receptor antagonists (MRA) (69.3%), Beta-blockers (54.2%), and lipid-lowering agents (46.0%). Currently, GDMT recommendations mainly include five types of drugs: diuretics, angiotensin receptor-neprilysin inhibitors (ARNIs), renin-angiotensin system inhibitors (ACEIs/ARBs), beta-blockers, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter-2 inhibitors (SGLT-2i). Among them, the utilization rates of ARNIs, SGLT-2i, triple therapy, and quadruple therapy are relatively low, accounting for 12.7%, 8.1%, 33.2%, and 3.75% respectively. The usage rates of these drugs are gradually increasing, especially after pharmacists participate in clinical decision-making and assist doctors in selecting therapeutic drugs, leading to a significant increase in the utilization rates of guideline-recommended drugs. Additionally, a multivariate logistic regression analysis of all drugs recommended by GDMT showed that ARBs (OR 0.681, CI 0.511–0.908), ARNIs (OR 0.191, CI 0.089–0.406), anticoagulants (OR 0.578, CI 0.403–0.829), tolvaptan (OR 0.340, CI 0.124–0.929), and SGLT-2i (OR 0.238, CI 0.058–0.969) significantly reduced the readmission rate of patients. Further subgroup analysis showed that the efficacy of the drugs varied slightly depending on the type of HF, but was consistent with guideline recommendations and clinical study results.ConclusionIn our hospital, the utilization rate of guideline-recommended drugs is gradually increasing, especially after pharmacists participate in rational drug use in clinical practice, the rate of increase is more significant, which is more in line with GDMT recommendations. Additionally, despite some limitations in our study, most of the guideline-recommended drugs show good therapeutic effects. And, we found that drugs such as SGLT-2i and ivabradine, despite their low usage rates, also demonstrate good therapeutic effects, providing significant implications for clinical decision-making. |
| format | Article |
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| institution | OA Journals |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-06-01 |
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| series | Frontiers in Pharmacology |
| spelling | doaj-art-bef2a9d40c6540a98d106710ff91b6232025-08-20T02:33:00ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-06-011610.3389/fphar.2025.15321231532123Heart failure medication treatment and prognosis: a retrospective cross-sectional studyQiankai Lin0Zongjie Lv1Daiyi Li2Qiao Ling3Sha Qiu4Xiaomei Lei5Fang Qin6Na Wang7Department of Pharmacy, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pharmacy, Chongqing Health Center for Women and Children/ Women and Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pharmacy, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pharmacy, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pharmacy, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pharmacy, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pharmacy, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaObjectiveHeart failure (HF) is a significant global public health concern and the leading cause of morbidity and mortality worldwide, imposing a substantial economic burden on society. Guideline-directed medical therapy (GDMT) refers to the standardized pharmacological treatment for specific diseases based on recommendations from authoritative clinical guidelines and evidence from large-scale randomized clinical trials. GDMT serves as the cornerstone of drug therapy for heart failure patients. This study describes hospitalized HF patients and focuses on drug prescription and readmission rates.MethodsThis study is a retrospective cross-sectional study with data from HF patients obtained from the Second Affiliated Hospital of Chongqing Medical University between January 2016 and June 2021. Patients were considered to have received GDMT if they were prescribed any guideline-recommended medication. Multilevel logistic regression was used to obtain the relationship between medication and readmission rates. The odds ratios (ORs) and 95% confidence intervals (CIs) have been reported.ResultsIn this study, a total of 5,356 HF patients (51.0% female; average age 77 years) were included. Among these patients, the most commonly used medications were mineralocorticoid receptor antagonists (MRA) (69.3%), Beta-blockers (54.2%), and lipid-lowering agents (46.0%). Currently, GDMT recommendations mainly include five types of drugs: diuretics, angiotensin receptor-neprilysin inhibitors (ARNIs), renin-angiotensin system inhibitors (ACEIs/ARBs), beta-blockers, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter-2 inhibitors (SGLT-2i). Among them, the utilization rates of ARNIs, SGLT-2i, triple therapy, and quadruple therapy are relatively low, accounting for 12.7%, 8.1%, 33.2%, and 3.75% respectively. The usage rates of these drugs are gradually increasing, especially after pharmacists participate in clinical decision-making and assist doctors in selecting therapeutic drugs, leading to a significant increase in the utilization rates of guideline-recommended drugs. Additionally, a multivariate logistic regression analysis of all drugs recommended by GDMT showed that ARBs (OR 0.681, CI 0.511–0.908), ARNIs (OR 0.191, CI 0.089–0.406), anticoagulants (OR 0.578, CI 0.403–0.829), tolvaptan (OR 0.340, CI 0.124–0.929), and SGLT-2i (OR 0.238, CI 0.058–0.969) significantly reduced the readmission rate of patients. Further subgroup analysis showed that the efficacy of the drugs varied slightly depending on the type of HF, but was consistent with guideline recommendations and clinical study results.ConclusionIn our hospital, the utilization rate of guideline-recommended drugs is gradually increasing, especially after pharmacists participate in rational drug use in clinical practice, the rate of increase is more significant, which is more in line with GDMT recommendations. Additionally, despite some limitations in our study, most of the guideline-recommended drugs show good therapeutic effects. And, we found that drugs such as SGLT-2i and ivabradine, despite their low usage rates, also demonstrate good therapeutic effects, providing significant implications for clinical decision-making.https://www.frontiersin.org/articles/10.3389/fphar.2025.1532123/fullheart failureGDMTretrospective cross-sectional studylogistic regressionreadmission rate |
| spellingShingle | Qiankai Lin Zongjie Lv Daiyi Li Qiao Ling Sha Qiu Xiaomei Lei Fang Qin Na Wang Heart failure medication treatment and prognosis: a retrospective cross-sectional study Frontiers in Pharmacology heart failure GDMT retrospective cross-sectional study logistic regression readmission rate |
| title | Heart failure medication treatment and prognosis: a retrospective cross-sectional study |
| title_full | Heart failure medication treatment and prognosis: a retrospective cross-sectional study |
| title_fullStr | Heart failure medication treatment and prognosis: a retrospective cross-sectional study |
| title_full_unstemmed | Heart failure medication treatment and prognosis: a retrospective cross-sectional study |
| title_short | Heart failure medication treatment and prognosis: a retrospective cross-sectional study |
| title_sort | heart failure medication treatment and prognosis a retrospective cross sectional study |
| topic | heart failure GDMT retrospective cross-sectional study logistic regression readmission rate |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1532123/full |
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