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  • Sequencing Quadruple Therapy for Heart Failure with Reduced Ejection Fraction: Does It Really Matter? Cardiology clinics Hu, J. R., Schwann, A. N., Tan, J. W., Nuqali, A., Riello, R. J., Beasley, M. H. 2023; 41 (4): 511-524

    Abstract

    The conventional sequence of guideline-directed medical therapy (GDMT) initiation in heart failure with reduced ejection fraction (HFrEF) assumes that the effectiveness and tolerability of GDMT agents mirror their order of discovery, which is not true. In this review, the authors discuss flexible GDMT sequencing that should be permitted in special populations, such as patients with bradycardia, chronic kidney disease, or atrial fibrillation. Moreover, the initiation of certain GDMT medications may enable tolerance of other GDMT medications. Most importantly, the achievement of partial doses of all four pillars of GDMT is better than achievement of target dosing of only a couple.

    View details for DOI 10.1016/j.ccl.2023.06.007

    View details for PubMedID 37743074