Expanded Results from a Dedicated Guideline-Directed Medical Therapy Clinic

Area of Science:

• Cardiology
• Heart Failure Management
• Clinical Practice Improvement

Background:

• Guideline-directed medical therapy (GDMT) for heart failure (HF) is underutilized in general cardiology settings.
• A dedicated GDMT clinic was expanded to encompass HF patients with the full spectrum of left ventricular ejection fraction (LVEF).

Purpose of the Study:

• To evaluate the effectiveness of a dedicated GDMT clinic in improving HF care across all LVEF.
• To compare outcomes of patients managed in the GDMT clinic versus usual care.

Main Methods:

• Patients were managed by advanced practice providers until maximally tolerated GDMT was achieved.
• Optimal GDMT achievement was assessed and compared to a 1:2 matched cohort receiving usual care.
• Key prognostic HF indicators, symptoms, and quality of life measures were evaluated.

Main Results:

• Optimal GDMT increased significantly in patients with LVEF <50% (12% to 91.3%) and LVEF ≥50% (5.6% to 77.8%).
• Substantial improvements were noted in symptoms, NT-proBNP levels, echocardiographic measurements, Kansas City Cardiomyopathy Questionnaire scores, and 6-minute walk distance.
• GDMT administration was safe and well-tolerated.

Conclusions:

• A dedicated GDMT clinic effectively improved key outcomes for HF patients across the entire LVEF spectrum.
• This model of care is well-tolerated and enhances patient well-being within a general cardiology practice.