{"id":7166,"date":"2025-05-29T10:27:25","date_gmt":"2025-05-29T07:27:25","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=7166"},"modified":"2025-05-29T10:27:25","modified_gmt":"2025-05-29T07:27:25","slug":"drug-quadruple-drug-combination-could-cut-heart-failure-mortality-by-60","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/drug-quadruple-drug-combination-could-cut-heart-failure-mortality-by-60\/","title":{"rendered":"\u201cDrug quadruple drug combination\u201d Could Cut Heart Failure Mortality by 60%"},"content":{"rendered":"
\u201cDrug quadruple drug combination\u201d Could Cut Heart Failure Mortality by 60%<\/div>\n
<\/div>\n
Source: Medscape.<\/div>\n
Published: May 15, 2025<\/div>\n
Key Points:<\/div>\n
1. Impact of Optimized Treatment:<\/span><\/div>\n
\u2022 Quadruple drug therapy can reduce chronic heart failure (HF) mortality by up to 60%.<\/span><\/div>\n
\u2022 Early initiation is crucial\u2014start treatment immediately after diagnosis.<\/span><\/div>\n
2. ESC 2021 Guidelines for HFrEF (LVEF \u2264 40%) and HFmrEF (41\u201349%):<\/span><\/div>\n
\u2022 Quadruple regimen includes:<\/span><\/div>\n
\u2022 ACE inhibitors or ARNI<\/span><\/div>\n
\u2022 Beta-blockers<\/span><\/div>\n
\u2022 MRAs<\/span><\/div>\n
\u2022 SGLT2 inhibitors<\/span><\/div>\n
\u2022 Loop diuretics added for volume overload.<\/span><\/div>\n
\u2022 Supported by studies like PARADIGM-HF and DAPA-HF.<\/span><\/div>\n
3. Delayed Diagnosis Is Common:<\/span><\/div>\n
\u2022 Only 29% of high-risk patients were diagnosed within 1 year in the REVOLUTION HF study.<\/span><\/div>\n
\u2022 Average delay: 40 days to get an echocardiogram.<\/span><\/div>\n
\u2022 Delayed diagnosis = delayed treatment = higher mortality.<\/span><\/div>\n
4. Treatment Initiation Sequence (Best Outcomes in 1 Year):<\/span><\/div>\n
\u2022 Week 1: Start SGLT2 inhibitors.<\/span><\/div>\n
\u2022 Week 2: Add MRAs (can be combined with SGLT2i).<\/span><\/div>\n
\u2022 Weeks 3\u20136: Titrate beta-blockers.<\/span><\/div>\n
\u2022 Weeks 4\u20139: Introduce ARNI, after BP stabilizes.<\/span><\/div>\n
5. Life Expectancy Gains:<\/span><\/div>\n
\u2022 +6.3 years for a 55-year-old switching to quadruple therapy.<\/span><\/div>\n
\u2022 +1.4 years even at age 80.<\/span><\/div>\n
6. Beyond Drugs \u2013 Device Therapy:<\/span><\/div>\n
\u2022 Consider pacemakers, ICDs, CRT and telemonitoring (often underused).<\/span><\/div>\n
\u2022 Treat arrhythmias proactively in HF patients with AF.<\/span><\/div>\n
7. Emerging Therapies:<\/span><\/div>\n
\u2022 Vericiguat (soluble guanylate cyclase stimulator) shows promise in those not responding to standard therapy.<\/span><\/div>\n
\u2022 Usable down to eGFR 15 mL\/min.<\/span><\/div>\n
\u2022 VICTOR trial results expected soon.<\/span><\/div>\n
8. Iron Deficiency in HF:<\/span><\/div>\n
\u2022 IV iron carboxymaltose improves exercise tolerance and reduces hospitalizations.<\/span><\/div>\n
\u2022 Meta-analysis of 6 trials shows 28% reduction in combined HF hospitalization\/CV death.<\/span><\/div>\n
9. HF with Preserved EF (HFpEF):<\/span><\/div>\n
\u2022 Current therapy includes SGLT2 inhibitors + diuretics, in addition to managing comorbidities.<\/span><\/div>\n
\u2022 However, the 2026 guidelines may also include new options.<\/span><\/div>\n
\u2022 The FINEARTS-HF study showed that finerenone (a nonsteroidal MRA) significantly reduced HF events and cardiovascular death, mainly by decreasing HF-related hospitalizations.<\/span><\/div>\n
\u2022 Finerenone is also used to prevent HF in diabetic nephropathy with albuminuria, and may have broader HF-specific roles in the future.<\/span><\/div>\n
https:\/\/click.mail.medscape.com\/?qs=1509cc4b7972953fff162317b26f8a39990a2a513b989d54dc38e87227604184ee39ffa88c0ac75acb902c555269bc76b8b5175e4d0312d5<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

\u201cDrug quadruple drug combination\u201d Could Cut Heart Failure Mortality by 60% Source: Medscape. Published: May 15, 2025 Key Points: 1. Impact of Optimized Treatment: \u2022 Quadruple drug therapy can reduce chronic heart failure (HF) mortality by up to 60%. \u2022 Early initiation is crucial\u2014start treatment immediately after diagnosis. 2. ESC 2021 Guidelines for HFrEF (LVEF […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-7166","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7166","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=7166"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7166\/revisions"}],"predecessor-version":[{"id":7167,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7166\/revisions\/7167"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=7166"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=7166"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=7166"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}