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However, the conventional approach to the implementation is based on a historically\u2010driven sequence that is not strongly evidence\u2010based, typically requires \u22656\u00a0months, and frequently leads to major gaps in treatment. We propose a rapid sequencing strategy that is based on four principles. First, since drugs act rapidly to reduce morbidity and mortality, patients should be started on all four foundational treatments within 2\u20134\u2009weeks. Second, since the efficacy of each foundational therapy is independent of treatment with the other drugs, priority can be determined by considerations of relative efficacy, safety and ease\u2010of\u2010use. Third, low starting doses of foundational drugs have substantial therapeutic benefits, and achievement of low doses of all four classes of drugs should take precedence over up\u2010titration to target doses. 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Rapid sequencing is a novel evidence\u2010based strategy that has the potential to dramatically improve the implementation of treatments that reduce the morbidity and mortality of patients with heart failure and a reduced ejection fraction.<\/jats:p>","DOI":"10.1002\/ejhf.2149","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T06:26:18Z","timestamp":1615443978000},"page":"882-894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":154,"title":["Rapid evidence\u2010based sequencing of foundational drugs for heart failure and a reduced ejection fraction"],"prefix":"10.1093","volume":"23","author":[{"given":"Milton","family":"Packer","sequence":"first","affiliation":[{"name":"Baylor University Medical Center  Dallas TX USA"},{"name":"Imperial College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John 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