According to a study published in the Journal of the American Medical Association Cardiology, among patients with heart failure with reduced ejection fraction (HFrEF), significant mortality benefits would result from the optimal use of guideline-directed medical therapy (GDMT).

The authors wrote, “Guideline-directed medical therapy (GDMT) remains underutilized on a global level, with significant disparities in access to treatment worldwide. The potential global benefits of quadruple therapy on patients with heart failure with reduced ejection fraction (HFrEF) have not yet been estimated.”

The study aimed to evaluate the projected population-level benefit of optimal GDMT use globally among patients with HFrEF. Estimates for HFrEF prevalence, contraindications to GDMT, treatment rates, and the number required to treat for all-cause mortality at 12 months were obtained from previously published literature.

The results revealed that 8,235,063 of an estimated 28.89 million people worldwide with HFrEF were potentially eligible for but not receiving β-blockers; 20,387,000 were eligible for but not receiving angiotensin receptor-neprilysin inhibitors; 12,223,700 were eligible for but not receiving mineralocorticoid receptor antagonists; and 21,229,170 were eligible for but not receiving sodium-glucose cotransporter-2 inhibitors.

The researchers discovered that with optimal implementation of quadruple GDMT, 1,188,277 deaths could potentially be prevented over 12 months, and many of these deaths were projected in Southeast Asia, the Eastern Mediterranean, Africa, and the Western Pacific regions.

The authors concluded that improving the use of GDMT could result in substantial mortality benefits on a global scale; however, substantial heterogeneity also exists across regions, which warrants additional study with interventions tailored to country-level variances for optimizing GDMT globally.

The authors wrote, “Even partial improvements in the use of GDMT has the potential to result in a substantial number of lives saved.”

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