Comprehensive Multidrug Therapy in Patients with Heart Failure and Reduced Ejection Fraction: How Much Would It Help?

Researchers attempt to estimate the cumulative benefits by reanalyzing three pivotal trials.

Pharmacotherapy for heart failure with reduced left-ventricular ejection fraction (HFrEF) has evolved dramatically over the last decades. Angiotensin-converting–enzyme inhibitor (ACEi) or angiotensin-receptor blocker (ARB) in addition to beta-blocker has long formed the basis of evidence-based therapy. More recent trials have proven the incremental benefits of other drug classes, including aldosterone antagonists, angiotensin-receptor-blocker–neprilysin inhibitor (ARNI), and sodium–glucose cotransporter 2 (SGLT-2) inhibitors. These researchers aimed to estimate the cumulative benefit of using all of these agents in individuals with HFrEF, based upon three pivotal clinical trials:

EMPHASIS-HF (aldosterone antagonist eplerenone vs. placebo in …

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)