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Heart Failure Guideline-Directed Medical Therapy (GDMT) - #MEDSHED

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Heart failure reduced ejection fraction (HFrEF) Guideline-Directed Medical Therapy


👿 Heart Failure Guideline-Directed Medical Therapy (GDMT) - #MEDSHED

🔥 GDMT has proven to reduce mortality and morbidity in patients with HFrEF (EF < 40%)

Drug classes include RAAS-I/ARNI, BB, MRA, and SGLT2-I


Entresto (sacubitril-valsartan) has shown to reduce all-cause death by 16% vs ACE-i

May consider RAAS-I (lisinopril, losartan, etc), switch to ARNI when clinically stable

📭 Beta Blockers

Beta blockers have been associated with a reduction in all-cause mortality by ~35%

Specific BB: bisoprolol, carvedilol, and metoprolol succinate


Spirinolactone may reduce the incidence of cardiovascular death and heart-failure associated hospitalization

Initiate after RAAS-I/ARNI and BB


Dapagliflozin and empagliflozin have shown to reduce all-cause death by 13% and hospitalizations by 25% in HFrEF with or without T2DM

Caution with volume status of patients on diuretics

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