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Muthiah Vaduganathan, MD: Real-World Impact of Comprehensive HFrEF Therapy

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Discussing the results of a recent analysis that estimated the impact of comprehensive therapy with SGLT2 inhibitors, ARNIs, and MRAs in patients with HFrEF.

While results of a recent study demonstrate a significant benefit from comprehensive therapy with mineralocorticoid receptor antagonists (MRAs), angiotensin receptor—neprilysin inhibitors (ARNIs), and sodium/glucose cotransporter 2 (SGLT2) inhibitors could have a major impact on event-free survival in patients with heart failure with reduced ejection fraction (HFrEF), several hurdles exist that prevent universal adoption of this treatment approach.

Results of the study, which were published in The Lancet, indicate this approach risk of cardiovascular events by 50%, risk of hospital admission for heart failure for 68%, and risk of all-cause mortality by 47%.

"Across a broad range of ages, these therapies, when implemented in combination, may meaningfully improve life expectancy and help patients remain out of the hospital," said lead author Muthiah Vaduganathan, MD, MPH, a cardiologist in Brigham and Women's Cardiovascular Division, in a statement.

An actuarial analysis using data from DAPA-HF, EMPHASIS-HF, and PARADIGM-HF, Vaduganathan and a team of colleagues assessed the potential impact of comprehensive HFrEF therapy on patients with HFrEF. Despite potential improvements in a myriad of areas, investigators noted multiple factors within their analysis limiting the applicability of these results to real-world settings, including cost and potential adverse effects of combining use of all these agents.

To learn more about the use of comprehensive therapy for HFrEF in real-world settings, HCPLive® invited Vaduganathan to take part in an HCPLive House Call.


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