Observational studyESC heart failure2021
Patient factors associated with titration of medical therapy in patients with heart failure with reduced ejection fraction: data from the QUALIFY international registry.
Observational study in ESC heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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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.
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Who cites it
18 citing papers in PubMed, 34 citations in OpenAlex.
- Observational
- Pharmacological treatments and clinical events in newly diagnosed heart failure patients stratified by ejection fraction in Japan.Scientific reports · 2026Article
- Polypill in heart failure: a pathway to simplified treatment and improved adherence and outcomes.Heart failure reviews · 2025Review
- Nurse-Led, Remote Optimisation of Guideline-Directed Medical Therapy in Patients with Heart Failure and Reduced Ejection Fraction Across Australia.Journal of clinical medicine · 2025Article
- Implementation of Medical Therapy in Different Stages of Heart Failure with Reduced Ejection Fraction: An Analysis of the VIENNA-HF Registry.Biomedicines · 2025Article
- Article
- Estimating the clinical and budgetary impact of using angiotensin receptor neprilysin inhibitor as first line therapy in patients with HFrEF.ESC heart failure · 2024Article
- Clinician challenges to evidence-based prescribing for heart failure and reduced ejection fraction: A qualitative evaluation.Journal of evaluation in clinical practice · 2023Article
- Guideline-directed medical therapy for HFrEF: sequencing strategies and barriers for life-saving drug therapy.Heart failure reviews · 2023Review
- Titration of medications and outcomes in multi-ethnic heart failure cohorts (with reduced ejection fraction) from Singapore and New Zealand.ESC heart failure · 2023Article
- A machine learning evaluation of patient characteristics associated with prescribing of guideline-directed medical therapy for heart failure.Frontiers in cardiovascular medicine · 2023Article
- Guideline-directed medical therapy is similarly effective in heart failure with mildly reduced ejection fraction.Clinical research in cardiology : official journal of the German Cardiac Society · 2023Observational
- Optimization of GDMT for patients with heart failure and reduced ejection fraction: can physiological and biological barriers explain the gaps in adherence to heart failure guidelines?Drugs in context · 2023Review
- Current Practices in Treating Cardiomyopathy and Heart Failure in Duchenne Muscular Dystrophy (DMD): Understanding Care Practices in Order to Optimize DMD Heart Failure Through ACTION.Pediatric cardiology · 2022Article
- Association between dosing and combination use of medications and outcomes in heart failure with reduced ejection fraction: data from the Swedish Heart Failure Registry.European journal of heart failure · 2022Article
- Changes in heart failure management and long-term mortality over 10 years: observational study.Open heart · 2022Observational
- Angiotensin-Converting Enzyme Inhibitor Dose Optimization and Its Associated Factors at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia.Vascular health and risk management · 2022Article
- Patient factors associated with titration of medical therapy in patients with heart failure with reduced ejection fraction: data from the QUALIFY international registry.ESC heart failure · 2021Observational
Corrections and comments
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Authors and funding
10 authors at 8 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsFailure to prescribe key medicines at evidence-based doses is associated with increased mortality and hospitalization for patients with Heart Failure with reduced Ejection Fraction (HFrEF). We assessed titration patterns of guideline-recommended HFrEF medicines internationally and explored associations with patient characteristics in the global, prospective, observational, longitudinal registry. METHODS AND
resultsData were collected from September 2013 through December 2014, with 7095 patients from 36 countries [>18 years, previous HF hospitalization within 1-15 months, left ventricular ejection fraction (LVEF) ≤ 40%] enrolled, with dosage data at baseline and up to 18 months from 4368 patients. In 4368 patients (mean age 63 ± 17 years, 75% male) ≥ 100% target doses at baseline: 30.6% (ACEIs), 2.9% (ARBs), 13.9% (BBs), 53.8% (MRAs), 26.2% (ivabradine). At final follow-up, ≥100% target doses achieved in more patients for ACEI (34.8%), BB (18.0%), and ivabradine (30.5%) but unchanged for ARBs (3.2%) and MRAs (53.7%). Adjusting for baseline dosage, uptitration during follow-up was more likely with younger age, higher systolic blood pressure, and in absence of chronic kidney disease or diabetes for ACEIs/ARBs; younger age, higher body mass index, higher heart rate, lower LVEF, and absence of coronary artery disease for BBs. For ivabradine, uptitration was more likely with higher resting heart rate.
conclusionsThe international QUALIFY Registry suggests that few patients with HFrEF achieve target doses of disease-modifying medication, especially older patients and those with co-morbidity. Quality improvement initiatives are urgently required.
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