GUIDELINE-DIRECTED MEDICAL THERAPY FOR HFrEF: SEQUENCING STRATEGIES AND BARRIERS FOR LIFE-SAVING DRUG THERAPY

Jishnu Malgie, Pascal R. D. Clephas, Hans-Peter Brunner-La Rocca, Rudolf A. de Boer, Jasper J. Brugts

The review highlights the introduction of four main drug classes into the 2021 ESC guidelines for HFrEF treatment, including angiotensin-receptor neprilysin inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors. It discusses the additive life-saving effects of these therapies and the urgency of achieving maximally tolerated doses quickly. The document also addresses the low adherence rates to GDMT and the various factors contributing to this challenge, including patient and healthcare system-related issues.