ReviewJACC. Heart failure2019
Initiation, Continuation, Switching, and Withdrawal of Heart Failure Medical Therapies During Hospitalization.
Review in JACC. Heart failure, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
75 citing papers in PubMed, 1 synthesis or guideline pooled it, 160 citations in OpenAlex.
- Severe acute respiratory syndrome coronavirus 2 and renin-angiotensin system blockers: A review and pooled analysis.Archives of cardiovascular diseases · 2020Pooled it
- The ADESTE trial: A phase 2 study of enibarcimab, a monoclonal antibody targeting adrenomedullin, in acute heart failure.ESC heart failure · 2025Trial
- In-hospital initiation of angiotensin receptor-neprilysin inhibition in acute heart failure: the PREMIER trial.European heart journal · 2024Trial
- Initiation of Angiotensin-Neprilysin Inhibition After Acute Decompensated Heart Failure: Secondary Analysis of the Open-label Extension of the PIONEER-HF Trial.JAMA cardiology · 2020Trial
- Prior Heart Failure Hospitalization, Clinical Outcomes, and Response to Sacubitril/Valsartan Compared With Valsartan in HFpEF.Journal of the American College of Cardiology · 2020Trial
- Safety of Inpatient and Outpatient Beta Blocker Initiation in Pediatric Heart Failure.Pediatric cardiology · 2026Article
- Prognostic Factors of Acute Heart Failure: A Regional Population Registry.Journal of cardiovascular development and disease · 2026Article
- Contemporary Guideline-Directed Medical Therapy for Heart Failure in the United States: The EMPACE Study.Journal of the American Heart Association · 2026Observational
- Heart Failure Pharmacotherapy and Long-Term Outcomes After Extracorporeal Membrane Oxygenation: A Nationwide Real-World Cohort Study.International journal of general medicine · 2026Article
- Early metoprolol use in ICU patients with congestive heart failure is associated with increased 30-day mortality: a causal machine learning study.Frontiers in pharmacology · 2026Article
- Impact of public assistance on long-term outcomes after hospitalization for acute heart failure.Frontiers in cardiovascular medicine · 2026Article
- Optimal Heart Rate Modulation Therapy Using Ivabradine in Individuals With Acute Heart Failure.Clinical cardiology · 2025Article
- Real-life implementation of guideline-recommended medical therapy in heart failure with reduced ejection fraction: Effects on prognosis and left ventricular ejection fraction. Primary results of TITRATE-HF.European journal of heart failure · 2025Observational
- Shifting Trends in Intensive Cardiovascular Care Unit Admission Patterns: Retrospective Insights and Prospective Implications.Diagnostics (Basel, Switzerland) · 2025Article
- Beta blockers linked to reduced 1-Year mortality in critically ill congestive heart failure patients with differential benefits across subgroups.Scientific reports · 2025Article
- Guideline-Directed Medical Therapy in Heart Failure: Is the Guideline-Practice Gap Narrowing?JACC. Asia · 2025Article
- Impact of polypharmacy on clinical outcomes in patients with advanced heart failure undergoing cardiac resynchronization therapy.Journal of arrhythmia · 2025Article
- Evolving Decongestion Strategies in the Management of Acute Heart Failure.Current treatment options in cardiovascular medicine · 2025Review
- Changes in Medication Complexity and Post-Hospitalization Outcomes in Older Adults Hospitalized for Heart Failure.Drugs & aging · 2025Article
- Impact of a structured educational intervention on attitudes and practice of heart failure in Latin America.Archivos de cardiologia de Mexico · 2025Article
15 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 5 institutions in 1 country.
Funding
Abstract
Patients with worsening heart failure with reduced ejection fraction (HFrEF) spend a large proportion of time in the hospital and other health care facilities. The benefits of guideline-directed medical therapy (GDMT) in the outpatient setting have been shown in large randomized controlled trials. However, the decision to initiate, continue, switch, or withdraw HFrEF medications in the inpatient setting is often based on multiple factors and subject to significant variability across providers. Based on available data, in well-selected, treatment-naïve patients who are hemodynamically stable and clinically euvolemic after stabilization during hospitalization for HF, elements of GDMT can be safely initiated. Inpatient continuation of GDMT for HFrEF appears safe and well-tolerated in most hemodynamically stable patients. Hospitalization is also a potential time for switching from an angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker to sacubitril/valsartan therapy in eligible patients, and is the subject of ongoing study. Therapy withdrawal or need for dose reduction is rarely required, but if needed identifies a particularly at-risk group of patients with progressive HF. If recurrent intolerance to neurohormonal blockers is observed, these patients should be evaluated for advanced HF therapies. There is an enduring need for using the teachable moment of HFrEF hospitalization for optimal initiation, continuation, and switching of GDMT to improve post-discharge patient outcomes and the quality of chronic HFrEF care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.