Association of multimorbidity with guideline-directed medical therapy intensification in heart failure: Findings from the EPIC-HF trial

Jonathan Lipsey; Larry A Allen; Robert L Page; Laura J Helmkamp; Grace Venechuk; Katy E Trinkley; Daniel D Matlock; Colleen K McIlvennan

doi:10.1016/j.heliyon.2024.e34178

Association of multimorbidity with guideline-directed medical therapy intensification in heart failure: Findings from the EPIC-HF trial

Heliyon. 2024 Jul 5;10(13):e34178. doi: 10.1016/j.heliyon.2024.e34178. eCollection 2024 Jul 15.

Authors

Jonathan Lipsey¹, Larry A Allen¹, Robert L Page¹, Laura J Helmkamp¹, Grace Venechuk¹, Katy E Trinkley², Daniel D Matlock^{3

4

5}, Colleen K McIlvennan¹

Affiliations

¹ Division of Cardiology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
² Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
³ Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
⁴ VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA.
⁵ Adult and Child Consortium for Outcomes Research and Delivery Science, USA.

Abstract

A potential contributor to the suboptimal rates of guideline directed medical therapy (GDMT) prescribing for heart failure with reduced ejection fraction (HFrEF) is the burden of multimorbidity in patients with HFrEF. We examined the effect of multimorbidity on GDMT prescription in the EPIC-HF trial, finding that multimorbidity was associated with decreased likelihood of GDMT intensification. Further study is needed to guide treatment in high-risk, multimorbid patients with HFrEF.