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
Affiliations
Jonathan Lipsey
Division of Cardiology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Larry A. Allen
Division of Cardiology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Robert L. Page
Division of Cardiology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Laura J. Helmkamp
Division of Cardiology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Grace Venechuk
Division of Cardiology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Katy E. Trinkley
Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Daniel D. Matlock
Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA; VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA; Adult and Child Consortium for Outcomes Research and Delivery Science, USA
Colleen K. McIlvennan
Division of Cardiology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Corresponding author. ClinicalTrials.gov University of Colorado, School of Medicine 12631 East 17th Avenue, B130 Aurora, CO, 80045, USA.
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.
