Clinical and Social Determinants of Guideline-Directed Medical Therapy Optimization in Heart Failure with Reduced Ejection Fraction

In 200 patients with new-onset HFrEF (index diagnosis 2024), low GDMT scores near 90 days were linked to higher eGFR and were less likely with diabetes and frequent medical visits.

• Why it matters: Even though GDMT improves HFrEF outcomes, disparities in how often patients receive recommended therapy persist, especially in safety-net settings.
• What they did: A single-center retrospective cross-sectional analysis used a standardized 0–9 GDMT scoring system from ambulatory data closest to 90 days after diagnosis, then applied multivariable logistic regression for low scores (0–4).
• The result: Low GDMT score was less likely with diabetes mellitus (adjusted OR 0.41, 95% CI 0.18–0.91) and frequent medical appointments (adjusted OR 0.37, 95% CI 0.25–0.54), while higher serum eGFR increased odds (adjusted OR 1.02, 95% CI 1.00–1.03); age, sex, race, and payer status showed no significant association.

AI summary of the abstract · may contain errors · not medical advice · read the paper.