Optimizing Guideline-directed Medical Therapies for Heart Failure with Reduced Ejection Fraction During Hospitalization

Heart failure remains a huge societal concern despite medical advancement, with an annual direct cost of over $30 billion. While guideline-directed therapy (GDMT) is proven to reduce morbidity and mortality, many eligible patients heart reduced ejection fraction (HFrEF) are not receiving one or more the recommended medications, often due suboptimal initiation titration in outpatient setting. Hospitalization serves as key point initiate titrate GDMT. Four evidence-based therapies have clinical benefit within 30 days form crucial foundation for HFrEF therapy: renin-angiotensin-aldosterone system inhibitors without neprilysin inhibitor, ?-blockers, mineralocorticoid-receptor-antagonists, sodium-glucose cotransporter-2 inhibitors. The authors present practical guide implementation these four pillars GDMT during hospitalization acute failure.