ReviewHeart failure reviews2023
Guideline-directed medical therapy for HFrEF: sequencing strategies and barriers for life-saving drug therapy.
Review in Heart failure reviews, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
What it found
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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.
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Who cites it
41 citing papers in PubMed, 51 citations in OpenAlex.
- The 'Chloride Theory' for Heart Failure Pathophysiology: An Updated Narrative Review 2025.Cardiology and therapy · 2026Review
- Comparative Effectiveness of Sacubitril/Valsartan Versus Sodium-Glucose Cotransporter 2 Inhibitors among Patients with Heart Failure with Reduced Ejection Fraction with or without Diabetes: A Cohort Study.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Article
- Cycloastragenol Attenuates Angiotensin II-Induced Cardiac Remodeling in Association with Enhanced EGFR Lysosomal Turnover and Changes in MAPK Signaling and Autophagy.Pharmaceuticals (Basel, Switzerland) · 2026Article
- [Lonicera japonica attenuates oxidative stress and improves post-ischemic heart failure in miceNan fang yi ke da xue xue bao = Journal of Southern Medical University · 2026Article
- The Real-World Use of Guideline-Directed Medical Therapy in Patients with Heart Failure with Reduced Ejection Fraction Newly Initiated on Dapagliflozin: An EVOLUTION-HF CEE-BA Study (Results from the Baltic Cohort).Medicina (Kaunas, Lithuania) · 2026Article
- Psychosocial factors, guideline-directed medical therapy, and healthcare resource use among patients newly diagnosed with heart failure in the United States.American heart journal plus : cardiology research and practice · 2026Article
- Official proceeding from the 2025 ITACARE-P National Meeting, Rome, October 21-22 2025: The added value of Cardiovascular Rehabilitation in heart failure management: clinical scenarios and expert opinion from a centres network of the Italian Alliance for Cardiovascular Rehabilitation and Prevention (ITACARE-P).International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Real-world evidence with dapagliflozin in heart failure with reduced ejection fraction in Central Eastern Europe and the Baltic region (EVOLUTION-HF CEE-BA Study).ESC heart failure · 2026Observational
- Determinants and Prognostic Impact of In-Hospital Sodium-Glucose Cotransporter-2 Inhibitor Initiation in Patients with Heart Failure.Clinical drug investigation · 2026Observational
- Impact of an assessment form on promoting in-hospital initiation of sodium-glucose cotransporter-2 inhibitors in hospitalized patients with heart failure.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Design, Rationale, and Methods of the INITIATE-HFrEF Trial: ARNI and SGLT2 Inhibitors Sequencing in HFrEF.JACC. Advances · 2026Article
- Characteristics and outcomes of patients with heart failure and reduced left ventricular ejection fraction in relation to sodium-glucose cotransporter-2 inhibitor treatment: real-world data from the multicentre HClinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Prevalence and clinical significance of guideline-directed medical therapy in acute heart failure with reduced or mildly reduced ejection fraction.Scientific reports · 2026Article
- Initiation of SGLT2 inhibitors versus mineralocorticoid receptor antagonists as third-line therapy in heart failure with reduced ejection fraction: a nationwide cohort study.The Lancet regional health. Europe · 2026Article
- Sacubitril/valsartan plus dapagliflozin improves cardiac function and reduces MACE and rehospitalization in hFrEF: a retrospective study.American journal of translational research · 2026Article
- 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
- Assisted therapy optimizing module to improve physician adhErence with guideLine-directed medical heart failure therapy rationale and design of the AMPEL trial.International journal of cardiology. Heart & vasculature · 2025Article
- The challenges of using electronic medical records (EMR) to facilitate guideline-directed medical therapy (GDMT) for patients with heart failure (HF) and chronic kidney disease (CKD).Heart failure reviews · 2025Review
- Adherence to Guideline-Directed Medical Therapy in Hospitalized Older People with Heart Failure at Discharge and 3-Month Follow-Up.Journal of clinical medicine · 2025Article
- Pharmacist-led guideline-directed medical therapy in heart failure: impact analysis in primary care.BMJ open quality · 2025Article
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 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Multiple landmark trials have helped to advance the treatment of heart failure with reduced ejection fraction (HFrEF) significantly over the past decade. These trials have led to the introduction of four main drug classes into the 2021 ESC guideline, namely angiotensin-receptor neprilysin inhibitors/angiotensin-converting-enzyme inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors. The life-saving effect of these therapies has been shown to be additive and becomes apparent within weeks, which is why maximally tolerated or target doses of all drug classes should be strived for as quickly as possible. Recent evidence, such as the STRONG-HF trial, demonstrated that rapid drug implementation and up-titration is superior to the traditional and more gradual step-by-step approach where valuable time is lost to up-titration. Accordingly, multiple rapid drug implementation and sequencing strategies have been proposed to significantly reduce the time needed for the titration process. Such strategies are urgently needed since previous large-scale registries have shown that guideline-directed medical therapy (GDMT) implementation is a challenge. This challenge is reflected by generally low adherence rates, which can be attributed to factors considering the patient, health care system, and local hospital/health care provider. This review of the four medication classes used to treat HFrEF seeks to present a thorough overview of the data supporting current GDMT, discuss the obstacles to GDMT implementation and up-titration, and identify multiple sequencing strategies that could improve GDMT adherence. Sequencing strategies for GDMT implementation. GDMT: guideline-directed medical therapy; ACEi: angiotensin-converting enzyme inhibitor; ARB: Angiotensin II receptor blocker; ARNi: angiotensin receptor-neprilysin inhibitor; BB: beta-blocker; MRA: mineralocorticoid receptor antagonist; SGLT2i: sodium-glucose co-transporter 2 inhibitor.
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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.