Chandrashekhar K Ponde, Jagdish C Mohan, Abraham Oomman, A Sreenivas Kumar, Prakash K Hazra, Uday M Jadhav
{"title":"印度专家共识：基于患者概况实施指南导向药物治疗（GDMT）治疗心力衰竭伴射血分数降低(HFrEF) - APPROACH-HF","authors":"Chandrashekhar K Ponde, Jagdish C Mohan, Abraham Oomman, A Sreenivas Kumar, Prakash K Hazra, Uday M Jadhav","doi":"10.1016/j.cardfail.2025.07.001","DOIUrl":null,"url":null,"abstract":"<p><p>Heart failure with reduced ejection fraction (HFrEF) is a significant contributor to impaired quality of life, hospitalizations and mortality, globally as well as in India. Early and rapid initiation of the 4 pillars of guideline-directed medical therapy (GDMT) has been shown to significantly improve the morbidity and mortality rates associated with HFrEF. However, despite robust clinical evidence and proven benefits, GDMT is significantly underused in clinical practice. Lack of simplified, yet patient-profile-tailored treatment protocols, concerns regarding the safety or tolerability of medications, and therapeutic inertia commonly contribute to underuse. An Indian expert consensus was developed by using the modified Delphi technique to address the GDMT underuse. This expert consensus provides guidance on the use of GDMT based on the patient profiles encountered commonly in clinical practice with the objective of aiding optimal GDMT use and, thereby, improving the clinical outcomes in patients with HFrEF.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":8.2000,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"An Indian Expert Consensus on Patient-Profile-Based Implementation of Guideline-Directed Medical Therapy in the Management of Heart Failure With Reduced Ejection Fraction: APPROACH-HF.\",\"authors\":\"Chandrashekhar K Ponde, Jagdish C Mohan, Abraham Oomman, A Sreenivas Kumar, Prakash K Hazra, Uday M Jadhav\",\"doi\":\"10.1016/j.cardfail.2025.07.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Heart failure with reduced ejection fraction (HFrEF) is a significant contributor to impaired quality of life, hospitalizations and mortality, globally as well as in India. Early and rapid initiation of the 4 pillars of guideline-directed medical therapy (GDMT) has been shown to significantly improve the morbidity and mortality rates associated with HFrEF. However, despite robust clinical evidence and proven benefits, GDMT is significantly underused in clinical practice. Lack of simplified, yet patient-profile-tailored treatment protocols, concerns regarding the safety or tolerability of medications, and therapeutic inertia commonly contribute to underuse. An Indian expert consensus was developed by using the modified Delphi technique to address the GDMT underuse. This expert consensus provides guidance on the use of GDMT based on the patient profiles encountered commonly in clinical practice with the objective of aiding optimal GDMT use and, thereby, improving the clinical outcomes in patients with HFrEF.</p>\",\"PeriodicalId\":15204,\"journal\":{\"name\":\"Journal of Cardiac Failure\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":8.2000,\"publicationDate\":\"2025-07-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cardiac Failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.cardfail.2025.07.001\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiac Failure","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cardfail.2025.07.001","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
An Indian Expert Consensus on Patient-Profile-Based Implementation of Guideline-Directed Medical Therapy in the Management of Heart Failure With Reduced Ejection Fraction: APPROACH-HF.
Heart failure with reduced ejection fraction (HFrEF) is a significant contributor to impaired quality of life, hospitalizations and mortality, globally as well as in India. Early and rapid initiation of the 4 pillars of guideline-directed medical therapy (GDMT) has been shown to significantly improve the morbidity and mortality rates associated with HFrEF. However, despite robust clinical evidence and proven benefits, GDMT is significantly underused in clinical practice. Lack of simplified, yet patient-profile-tailored treatment protocols, concerns regarding the safety or tolerability of medications, and therapeutic inertia commonly contribute to underuse. An Indian expert consensus was developed by using the modified Delphi technique to address the GDMT underuse. This expert consensus provides guidance on the use of GDMT based on the patient profiles encountered commonly in clinical practice with the objective of aiding optimal GDMT use and, thereby, improving the clinical outcomes in patients with HFrEF.
期刊介绍：
Journal of Cardiac Failure publishes original, peer-reviewed communications of scientific excellence and review articles on clinical research, basic human studies, animal studies, and bench research with potential clinical applications to heart failure - pathogenesis, etiology, epidemiology, pathophysiological mechanisms, assessment, prevention, and treatment.
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