Related Experiment Video

Updated: Jan 9, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

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Additive Benefit of Guideline-Directed Medical Therapies at Discharge in Reducing 30-Day Readmissions in Heart

Andrew Willeford1, Barry Greenberg2, Zaid Yousif1

  • 1UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, California, USA.

JACC. Advances
|December 5, 2025
PubMed

Insights

Increasing guideline-directed medical therapy (GDMT) prescriptions at heart failure (HF) discharge significantly lowers 30-day readmission rates. Optimizing GDMT use can reduce healthcare costs and improve hospital performance.

Area of Science:

  • Cardiology
  • Health Services Research

Background:

  • Heart failure (HF) hospitalizations incur substantial healthcare costs in the US.
  • Guideline-directed medical therapy (GDMT) is underutilized at discharge, contributing to high HF readmission rates.
  • Understanding the impact of GDMT at discharge can guide initiatives to improve patient outcomes and reduce costs.

Purpose of the Study:

  • To investigate the association between the number of GDMT prescriptions at discharge and 30-day readmissions in HF patients.
  • To quantify the impact of varying GDMT counts on all-cause and HF-specific readmission hazards.

Main Methods:

  • Retrospective cohort study of 2,121 HF hospitalizations across 5 institutions (February 2021 - October 2024).
  • Included adult patients with left ventricular ejection fraction ≤40%.
  • Used multivariable mixed-effects Cox proportional hazard models to analyze the relationship between GDMT count and 30-day readmission rates.

Main Results:

  • Each additional GDMT prescription at discharge was associated with a significant reduction in 30-day all-cause readmission hazard.
  • Compared to 1 GDMT, 2 GDMTs showed HR 0.79 (95% CI: 0.64-0.97), 3 GDMTs HR 0.70 (95% CI: 0.55-0.90), and 4 GDMTs HR 0.56 (95% CI: 0.40-0.77).
  • Similar trends were observed for 30-day HF-specific readmissions.

Conclusions:

  • A dose-dependent relationship exists between the number of GDMT classes prescribed at discharge and reduced 30-day readmissions for HF.
  • Implementing comprehensive GDMT strategies at discharge can potentially lower healthcare expenditures and improve institutional quality metrics.
Abstract

Keywords:
guideline-directed medical therapyheart failurehospital readmissionpatient dischargeregistries

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