{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T05:20:27Z","timestamp":1793337627054,"version":"4.5.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":79,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Despite guideline recommendations, guideline-directed medical therapy (GDMT) remains underused and underdosed in patients with heart failure (HF) across the ejection fraction (EF) spectrum. The aim of this study was to evaluate GDMT use, dosing, and implementation in a contemporary, nationwide HF cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The OPTIPHARM-HF (NCT06192524) is a prospective, multicentre, observational study enrolling adult patients with HF, across 32 Italian HF centres. Clinical characteristics, medical therapy prevalence and change after first visit have been assessed in patients with reduced (HFrEF: EF \u226440%), mildly reduced (HFmrEF: EF 40\u201349%), and preserved EF (HFpEF: EF \u226550%). From September 2022 to December 2024, 3054 patients (mean age 69\u2009\u00b1\u200912\u2009years, 25% female) were enrolled: 56% with HFrEF, 21% with HFmrEF, and 23% with HFpEF. Among HFrEF, prescription frequencies were: 90% for beta-blockers; 19% for angiotensin-converting enzyme inhibitors (ACEi)\/angiotensin II receptor blockers (ARB); 61% for angiotensin receptor\u2013neprilysin inhibitors (ARNI); 72% for mineralocorticoid receptor antagonists (MRA); and 69% for sodium\u2013glucose co-transporter 2 inhibitors (SGLT2i). Less than 60% achieved \u226550% of target doses. Quadruple therapy was received by 47% of the patients. After first visit, there was an increase in prescription of all classes of drugs, and titration to quadruple therapy was attained in 64% (p\u2009&amp;lt;\u20090.001). Among HFmrEF, 88% were on beta-blockers, 34% on ACEi\/ARB, 49% on ARNI, 63% on MRA, and 59% on SGLT2i. In the HFpEF group, 76% were on beta-blockers, 49% on ACEi\/ARB, 18% on ARNI, 49% on MRA and 40% on SGLT2i. After the first visit, SGLT2i prescription significantly increased both in HFmrEF (74%, p\u2009&amp;lt;\u20090.001) and HFpEF (54%, p\u2009&amp;lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Use of GDMT remains suboptimal across the EF spectrum although the adoption of quadruple GDMT in HFrEF and of SGLT2i in HFmrEF and HFpEF increased in recent years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.70074","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T07:16:33Z","timestamp":1766042193000},"page":"2691-2704","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Contemporary Medical Therapy for Heart Failure Across the Ejection Fraction Spectrum: The OPTIPHARM-HF Registry"],"prefix":"10.1093","volume":"27","author":[{"given":"Riccardo M.","family":"Inciardi","sequence":"first","affiliation":[{"name":"Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]},{"name":"Division of Cardiology, Department of Clinical Science and Education, Center for Heart Failure and Arrhythmia, Karolinska University Hospital , Stockholm ,","place":["Sweden"]},{"name":"Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Volterrani","sequence":"additional","affiliation":[{"name":"Department of Exercise Science and Medicine, San Raffaele Open University of Rome, Italy, and Cardiopulmonary Department, RCCS San Raffaele Roma , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Savarese","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Clinical Science and Education, Center for Heart Failure and Arrhythmia, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School , Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Oriecuia","sequence":"additional","affiliation":[{"name":"Department of Molecular and Translational Medicine, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo M.","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Gussago","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiuseppe","family":"Agostoni","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS, Department of Clinical Sciences and Community Health , Milan ,","place":["Italy"]},{"name":"Department of Clinical and Community Medicine, University of Milan , Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Ameri","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino , Genoa ,","place":["Italy"]},{"name":"Department of Internal Medicine, University of Genoa , Genoa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Armentaro","sequence":"additional","affiliation":[{"name":"Geriatrics Division. AOU R. Dulbecco, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro , Catanzaro ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Arzilli","sequence":"additional","affiliation":[{"name":"Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Aspromonte","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular ad Thoracic Sciences, Fondazione Policlinico Universitario A. 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