{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T16:19:47Z","timestamp":1769357987954,"version":"3.49.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1752,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Treatment with angiotensin converting enzyme inhibitor (ACEi)\/angiotensin II receptors blockers (ARBs) and beta-blockers is frequently suboptimal at discharge in patients hospitalized for acute heart failure (AHF). We investigated the prognostic significance of medical treatment at discharge and its changes during hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In a retrospective analysis, we included 623 patients hospitalized for AHF with reduced left ventricular ejection fraction (&amp;lt;40%). The primary endpoint was all-cause mortality and heart failure rehospitalization to Day 180 since hospital discharge. A total of 249 (42.4%) of patients received no ACEi\/ARBs\/BB or &amp;lt;50% target dose (TD) of these drugs, 249 (42.4%) had either ACEi\/ARBs or BB \u2265 50% of TD, and 89 (15.2%) ACEi\/ARBs and BB \u2265 50% of TD at discharge. The primary endpoint was significantly lower in patients receiving at least one drug \u226550% of TD compared with no or low-dose treatment (ACEi\/ARBs or BB \u2265 50% TD: adjusted hazard ratio (HR) 0.69, 95% confidence interval (CI) [0.49\u20130.98], P = 0.04; ACEi\/ARBs and BB \u2265 50% TD: adjusted HR 0.54, 95% CI [0.30\u20130.96], P = 0.03). With regard to treatment changes from admission to discharge, therapy was decreased in 258 (44.6%) patients, stable in 194 (33.6%), and increased in 126 (21.8%). Compared with patients with stable therapy, treatment intensification was associated with a lower rate of the primary endpoint (adjusted HR 0.49, 95% CI [0.29\u20130.83]; P = 0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with AHF, prescription of ACEi\/ARBs\/BB \u2265 50% TD at the time of discharge, whether achieved or not through treatment intensification during the hospitalization, is associated with better post-discharge outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13223","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T07:53:52Z","timestamp":1614844432000},"page":"1944-1953","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Adherence and Optimization of Angiotensin Converting Enzyme Inhibitor\/Angiotensin II Receptors Blockers and Beta-Blockers in Patients Hospitalized for Acute Heart Failure"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9430-9820","authenticated-orcid":false,"given":"Valentina","family":"Carubelli","sequence":"first","affiliation":[{"name":"Division of Cardiology, ASST Spedali Civili di Brescia, University and Civil Hospital of Brescia , Brescia ,","place":["Italy"]},{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, ASST Spedali Civili di Brescia, University and Civil Hospital of Brescia , Brescia ,","place":["Italy"]},{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Specchia","sequence":"additional","affiliation":[{"name":"Department of Molecular and Translational Medicine, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Peveri","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Oriecuia","sequence":"additional","affiliation":[{"name":"Department of Molecular and Translational Medicine, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Tomasoni","sequence":"additional","affiliation":[{"name":"Division of Cardiology, ASST Spedali Civili di Brescia, University and Civil Hospital of Brescia , Brescia ,","place":["Italy"]},{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattia","family":"Di Pasquale","sequence":"additional","affiliation":[{"name":"Division of Cardiology, ASST Spedali Civili di Brescia, University and Civil Hospital of Brescia , Brescia ,","place":["Italy"]},{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Inciardi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, ASST Spedali Civili di Brescia, University and Civil Hospital of Brescia , Brescia ,","place":["Italy"]},{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emirena","family":"Garrafa","sequence":"additional","affiliation":[{"name":"Department of Molecular and Translational Medicine, University of Brescia , Brescia ,","place":["Italy"]},{"name":"Department of Laboratory Diagnostics, ASST Spedali Civili , Brescia ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Division of Cardiology, ASST Spedali Civili di Brescia, University and Civil Hospital of Brescia , Brescia ,","place":["Italy"]},{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia 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