ArticleCirculation reports2025
Effectiveness of Guideline-Directed Medical Therapy for Acute Heart Failure With Reduced Ejection Fraction in Frail Elderly Patients With Malnutrition.
Article in Circulation reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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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.
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Who cites it
3 citing papers in PubMed.
- Relationship Between Leg Muscle Strength and Muscle Oxygenation Dynamics During Incremental Exercise in Patients With Heart Failure.Circulation reports · 2026Article
- Impact of Preoperative Malnutrition and Sarcopenia on Clinical Outcomes After Transcatheter Aortic Valve Replacement.Circulation reports · 2026Article
- Pancreatic Exocrine Function in Hospitalized Patients Following Acute Decompensated Heart Failure - An Observational Cross-Sectional Study.Circulation reports · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The appropriateness of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) in malnourished elderly patients is unclear. This study aims to assess the effects of GDMT on acute heart failure (AHF) with reduced ejection fraction in this specific population using the Geriatric Nutritional Risk Index (GNRI). Methods and Results: We retrospectively collected data of patients aged >75 years who were admitted to St. Luke's International Hospital for AHF with reduced ejection fraction from 2011 to 2022. Malnutrition was defined as a GNRI score <92. GDMT was defined as the prescription of 3 or more of the medications for HFrEF at the time of discharge. Among 467 patients, 345 (73.9%) had malnutrition. In the low GNRI group, GDMT was associated with a lower all-cause mortality at 1 year (HR 0.46; 95% CI 0.24-0.89; P=0.021), but not in heart failure (HF) readmission (HR 0.83; 95% CI 0.55-1.25; P=0.364) at 1 year after discharge. In the high GNRI group, GDMT was not significantly associated with these outcomes (all-cause mortality: HR 0.59; 95% CI 0.12-3.06; P=0.534; HF readmission: HR 0.55; 95% CI 0.29-1.05; P=0.069). Conclusions: Implementation of GDMT in AHF with reduced ejection fraction may enhance prognosis, even among elderly patients with malnutrition.
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