Enhancing Heart Failure Care Through Registries: Lessons Learned from Nordic Countries' Implementation of Guidelines

This review evaluates the role of heart failure (HF) registries in the Nordic countries-Sweden, Denmark, Norway, and Iceland-in the implementation of the European Society of Cardiology's guidelines for guideline-directed medical therapy (GDMT) in heart failure with reduced ejection fraction (HFrEF). It critically examines how these registries facilitate clinical practice and enhance patient outcomes through their design, data collection methods, and the evaluation of key metrics related to GDMT implementation over time. We highlight the nurse-led models adopted by these registries, which emphasize quality benchmarks and feature real-time feedback mechanisms regarding the application of GDMT. Between 2021 and 2024, registry population-weighted estimates revealed significant increases in the utilization of key therapies: mineralocorticoid receptor antagonists rose from 51% to 72%, sodium-glucose co-transporter-2 inhibitors from 20% to 81%, and sacubitril/valsartan from 22% to 32%. The use of beta-blockers and renin-angiotensin-system inhibitors remained consistently high at 91% and 94%, respectively. These shifts were linked to better treatment outcomes. The findings underscore that HF registries play a crucial role in enhancing care quality through established drug therapies for HFrEF, offering a model for integrating data-driven methodologies into HF management. Future utilization and expansion of these registries are vital for tackling healthcare disparities and refining treatment strategies for HF patients.