Adherence to gdmt treatment for heart failure out-patients – single center registry

Abstract

Background: GDMT treament has demonstrated to heart failure can improve heart failure survival and reduce hospital admission.
 Objective: This study evaluated the use of guideline-directed medical therapy (GDMT) for heart failure with reduced and mild reduced ejection fraction (HFrEF) in outpatient department in Hanoi Heart Hospitaland its impact on patients’ midterm outcome. 
 Method: Medical records of 1131 patients with HFrEF and HFmrEF followed at Hanoi Heart Hosspital, facility 1 From September 2019 to March 2021 were reviewed. The prescription rates of recommended pharmacological agents and their dosages were evaluated.
 Results: The population includes 711 male (62.9%) and 420 female (37.1%), with an average age of 64,96 ± 14,49 years. The mean and median time of follow up were 10,59 ± 2,77 month (the shortest follow-up time was 3 months, the longest was 15 months). The prescription rate of β-blockers, ACEI/ARB/ARNI, MRA were 74.36%, 80.9% and 69.5% respectively. After follow-up, these rates were 86.75%, 86.52% and 68.9%, correspondingly. After follow-up, the highest rate of prescription over 50% dosages of these drugs in the range given were Spiranolactone, it was achieved 56.15%, followed by Losartan, Bisoprolol, Nebivolol, all above 30%. The initial LVEF was 37.93 ± 8.58%, and at the end of the follow – up period, the LVEF achieved 40.26 ± 9.44%, significantly improved. 168 patients (14.85%) were admitted to the hospital at least once during the follow-up period; mong them, 133 patients (79.2%) were hospitalized once, 30 patients (17.8%) were hospitalized twice, and five patients (3.0%) were hospitalized at least three times. Mortality was 1.9% (18 patients) during the follow-up period. [1]
 Conclusion: The rate of heart failure GDMT drugs using for outpatients in our center is rather high but there are gaps that need to be filled to enhance the outcome of HFrEF and HFmrEF patients.