Early Initiation of Guideline Directed Medical Therapy for Heart Failure Following Cardiac Surgery

Author Department

Surgery

Document Type

Article, Peer-reviewed

Publication Date

6-2024

Abstract

There is an evolving role for guideline directed medical therapy (GDMT) in managing heart failure with reduced ejection fraction (HFrEF) following cardiac surgery. GDMT is based on the use of pharmacological agents from each of the four distinct drug classes, also known as the four pillars of heart failure therapy; beta blockers, renin-angiotensin system inhibitors often paired with neprilysin inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors. Despite the demonstrated benefits of GDMT in reducing mortality and hospitalization rates in the non-surgical literature, there is conspicuous underutilization of GDMT following cardiac surgery. The lack of published literature and practical challenges surrounding the timing for initiation of GDMT in the immediate postoperative period have limited standardized implementation strategies. A multidisciplinary approach will be necessary to assist in initiating, titrating, and monitoring the response to these therapies in HFrEF patients following cardiac surgery.

Keywords: Guideline Directed Medical Therapy; Heart Failure with Reduced Ejection Fraction; Post-Cardiac Surgery.

PMID

38878947

Link to Full Text

Share

COinS