A scoring evaluation for the practical introduction of guideline‐directed medical therapy in heart failure patients

Aims The guideline‐directed medical therapy (GDMT) has been recommended for heart failure (HF) with reduced ejection fraction (HFrEF) based on the accumulating clinical evidence. However, it is difficult to implement all the trial‐proven medications for every patient in the real world. Methods and results A simple GDMT score was created, according to the combination of GDMT drugs (renin–angiotensin system inhibitors, beta‐blockers, mineralocorticoid receptor antagonists, and sodium–glucose transporter 2 inhibitors) administration and their dosage (0–9 points). Its impact on the prognosis of HF patients was investigated. Admitted HF patients [HFrEF and HF with mildly reduced ejection fraction (HFmrEF), n = 1054] were retrospectively analysed (excluding those with in‐hospital death and dialysis). A simple GDMT score ≥5, but not the number of medications, was significantly associated with a reduction of all‐cause death, HF readmission, and composite outcome (HF readmission and all‐cause death) (P