Observational studyBMJ open2025
Temporal trends in guideline-recommended medical therapy after an acute heart failure decompensation event: an observational analysis from Generator Heart Failure DataMart.
Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 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
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Victoria and Victor: event-driven lessons for integrating vericiguat into practice and reducing residual risk in HFrEF.Heart failure reviews · 2025Review
- Impact of socio-demographic and ethnic determinants in guideline-directed medical therapy implementation during heart failure hospitalization.European heart journal open · 2025Article
- Right ventricular strain predicts outcome in patients receiving sacubitril/valsartan: A sub-analysis of DISCOVER-ARNI.ESC heart failure · 2025Article
- 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
- Study design and rationale of the AZIMUTH trial: a smartphone, app-based, E-health-integrated model of care for heart failure patients.European heart journal. Digital health · 2025Article
- Device-based Strategies for Monitoring Congestion and Guideline-directed Therapy in Heart Failure: The Who, When and How of Personalised Care.Cardiac failure review · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the trend of prescription of the four foundational therapies, and their impact on 30-day urgent re-admissions and all-cause death in patients with heart failure and reduced ejection fraction (HFrEF) following an acute decompensation event.
designRetrospective.
settingOne tertiary referral centre.
participants999 consecutively patients admitted with a primary diagnosis of HFrEF between January 2020 and June 2023 were identified through a validated, high-performance technology infrastructure based on artificial intelligence. The entire cohort was divided into three time periods based on two time points: September 2021 (ie, the release of the latest European guidelines) and January 2022 (ie, reimbursement for sodium-glucose cotransporter 2 (SGLT2) inhibitors). PRIMARY AND SECONDARY OUTCOME MEASURES: Trends and predictors of the prescription of each of the four foundational therapies and of the composite of all-cause death and rehospitalisation for urgent causes at 30 days.
resultsAmong the 999 included patients, β-blockers were prescribed in 93% of patients, ACE inhibitor (ACEi)/angiotensin receptor blocker (ARB)/angiotensin-neprilysin receptor inhibitor (ARNi) in 73%, mineralocorticoid receptor antagonist in 30% and SGLT2 inhibitors in 18%. Over time, an increase in the prescription rate occurred only for SGLT2 inhibitors (3% vs 10% vs 32%, p<0.001), whereas the rate of the composite of all-cause death and rehospitalisation for urgent causes at 30 days remained stable (9.9% vs 10.3% vs 8.4%; p=ns). In multivariate analysis, the use of ACEi/ARB/ARNi was associated with a lower risk of 30-day all-cause death and urgent rehospitalisation (adjusted OR 0.38; 95% CI 0.24 to 0.59; p<0.01). Conversely, the prescription of furosemide at discharge (adjusted OR 2.25; 95% CI 95% 1.29 to 3.94; p<0.01) and a previous genitourinary infection (adjusted OR 4.02; 95% CI 1.67 to 9.68; p<0.01) were associated with higher risk of 30-day all-cause death and urgent rehospitalisation.
conclusionsIn our study, early adoption of guideline-recommended medical therapy is still limited, with a significant rise in SGLT2i prescriptions after January 2022 and a lower risk of the composite of all-cause death and urgent readmissions at 30 days restricted to the use of ACEi/ARB/ARNi.
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What Socratic 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 Socratic graph.