Evaluating Adherence to Guideline-Directed Medical Therapy in Patients With Advanced Heart Failure

Summary

A Prospective Observational, Multi-Center, Real-World Pharmacological Study Evaluating Adherence to Guideline-Directed Medical Therapy Using the Four-Pillar Strategy in Patients with Advanced Heart Failure

Eligibility

Inclusion Criteria:

1. Age \> 18 and \< 75 years
2. Heart failure with left ventricular ejection fraction ≤ 35%
3. Persistent symptoms of heart failure, New York Heart Association class III or IV
4. Requirement for high-dose diuretic therapy, specifically Furosemide \> 50 mg/day orally as per routine clinical practice
5. At least one of the following additional indicators of severity or refractoriness:
6. need for progressive escalation of diuretics,
7. intolerance to optimized medical therapy,
8. persistence of symptoms despite advanced treatments such as (but not limited to) cardiac resynchronization therapy (CRT-D)and/or MitraClip
9. Ability and willingness to provide written informed consent for participation and for the processing of clinical data for research purposes

Exclusion Criteria:

1. Age ≤ 18 years or ≥ 75 years
2. Left ventricular ejection fraction \> 35%
3. Mild or absent symptoms (New York Heart Association class I-II)
4. Good response to optimized conventional guideline-directed medical therapy
5. Extreme frailty or severe non-reversible disability, or psychiatric or cognitive disorders preventing adherence to follow-up
6. Pregnant or breastfeeding women

Conditions2

Interventions1

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