Withdrawal of Guideline-Directed Medical Therapy in Patients With Heart Failure and Improved Ejection Fraction
In patients with HF with improved EF, HF therapy withdrawal was rare. Withdrawing RASi/ARNi and MRA was associated with higher mortality/morbidity at 1 year. No association was found for BBL withdrawal, albeit with a significant heterogeneity for EF at improvement, suggesting better outcomes with continuing BBL only until EF improves up to 50%. These results are hypothesis-generating and highlight the need for randomized controlled trials testing BBL withdrawal in patients with HF with improved EF.
Authors
- Peter G. M. Mol (ORCID: https://orcid.org/0000-0002-4262-3180)
- Gianluigi Savarese (ORCID: https://orcid.org/0000-0001-7732-0887)
- Christian Basile (ORCID: https://orcid.org/0000-0002-4680-3058)
- Federica Guidetti (ORCID: https://orcid.org/0009-0005-1659-7731)
- Lina Benson (ORCID: https://orcid.org/0000-0002-5393-0055)
- Lars H. Lund (ORCID: https://orcid.org/0000-0003-1411-4482)
- Felix Lindberg (ORCID: https://orcid.org/0000-0002-7380-9877)
- Ulf Dahlström (ORCID: https://orcid.org/0000-0001-6353-8041)
- Massimo Piepoli (ORCID: https://orcid.org/0000-0003-1124-234X)
- Aldo P. Maggioni (ORCID: https://orcid.org/0000-0003-2764-6779)
- R Scorza (ORCID: https://orcid.org/0000-0002-4781-9588)
Institutions
- Linköping University (SE)
- University Medical Center Groningen (NL)
- Karolinska University Hospital (SE)
- University of Milan (IT)
- Karolinska Institutet (SE)
- Stockholm South General Hospital (SE)
- Associazione Nazionale Medici Cardiologi Ospedalieri (IT)
- IRCCS Policlinico San Donato (IT)
- Federico II University Hospital (IT)
- Centre for Multidisciplinary Research in Health Science (IT)
Publication Details
- Journal
- Circulation
- Published
- 2025-03-17
- DOI
- https://doi.org/10.1161/circulationaha.124.072855
- Citations
- 19
- Primary Topic
- Heart Failure Treatment and Management
- Type
- article
- Field-Weighted Citation Impact
- 26.38