Analysis and evaluation of guideline-directed medical therapy in chronic heart failure inpatients with reduced ejection fraction in a third level hospital

DOI: 10.12201/bmr.202507.00076

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  Abstract: Objective: To investigate the current status and rationality of guideline-directed medical therapy (GDMT) in inpatients with chronic heart failure with reduced ejection fraction (HFrEF) in Wenling Hospital of Traditional Chinese Medicine, and provide references for clinical drug use. Methods: The clinical date of HFrEF patients admitted to the Department of Cardiology of our hospital and the application of GDMT-related medications including angiotensin receptor neprilysin inhibitor (ARNI) / angiotensin converting enzyme inhibitor (ACEI) / angiotensin II receptor blocker (ARB), β-blocker (BB), mineralocorticoid receptor antagonist (MRA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) were retrospectively analyzed from 2022 to 2024. The rationality of drug use were evaluated according to relevant guidelines, consensus and drug instructions. Results: A total of 117 patients were included, among which 73.50% were male, and the average age was (69.62±14.39) years old. The proportion of patients receiving ARNI/ACEI/ARB, BB, MRA and SGLT2i was 77.78%, 63.25%, 97.44% and 68.38%, respectively. The rates of reaching target dose were 2.20%, 0.00%, 100.00% and 98.75%, respectively. Single, double, triple and quadruple anti-heart failure drugs accounted for 5.98%, 23.08%, 29.06% and 41.88%, respectively. Conclusion: There is still a certain gap between clinical practice and guideline in the utilization of the GDMT-realted medications in patients with chronic HFrEF in our hospital. The usage rate of BB was low, and the dosage of ARNI/ACEI/ARB and BB were seriously insufficient, while MRA was overused. The standardization of GDMT medication needs further improvement.

  Key words: Heart failure with reduced ejection fraction; Guideline-directed medical therapy; Drug evaluation

  Submit time: 29 July 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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