{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T15:04:20Z","timestamp":1771945460270,"version":"3.50.1"},"reference-count":30,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.es","elsevier.es","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Medicina Cl\u00ednica"],"published-print":{"date-parts":[[2026,1]]},"DOI":"10.1016\/j.medcli.2025.107247","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T07:55:49Z","timestamp":1768290949000},"page":"107247","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Initiation and titration of guideline-directed medical therapy during hospitalization for acute decompensation of heart failure with reduced ejection fraction"],"prefix":"10.1016","volume":"166","author":[{"given":"Sandra","family":"Valdivielso Mor\u00e9","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00faria","family":"Farr\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neus","family":"Badosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00faria Rodr\u00edguez","family":"de Francisco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laia Carla","family":"Belarte-Tornero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald O.","family":"Morales Murillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Vime-Jubany","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miren","family":"Vicente Elcano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Jose","family":"Ochoa Segarra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Ruiz-Rodriguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Mar\u00eda","family":"Lin\u00e1s-Alonso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicidad","family":"Martinez-Medina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Vaquerizo Montilla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Ruiz-Bustillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.medcli.2025.107247_bib0155","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"10.1016\/j.medcli.2025.107247_bib0160","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.amjcard.2018.01.006","article-title":"Effect of optimizing guideline-directed medical therapy before discharge on mortality and heart failure readmission in patients hospitalized with heart failure with reduced ejection fraction","volume":"121","author":"Yamaguchi","year":"2018","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.medcli.2025.107247_bib0165","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1002\/ejhf.549","article-title":"Medical resource use and expenditure in patients with chronic heart failure: a population-based analysis of 88 195 patients","volume":"18","author":"Farr\u00e9","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.medcli.2025.107247_bib0170","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jchf.2020.08.017","article-title":"Heart failure hospitalization and guideline-directed prescribing patterns among heart failure with reduced ejection fraction patients","volume":"9","author":"Srivastava","year":"2021","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.medcli.2025.107247_bib0175","doi-asserted-by":"crossref","first-page":"3627","DOI":"10.1093\/eurheartj\/ehad195","article-title":"2023 focused update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"44","author":"McDonagh","year":"2023","journal-title":"Eur Heart J"},{"key":"10.1016\/j.medcli.2025.107247_bib0180","doi-asserted-by":"crossref","first-page":"2573","DOI":"10.1093\/eurheartj\/ehac210","article-title":"Accelerated and personalized therapy for heart failure with reduced ejection fraction","volume":"43","author":"Shen","year":"2022","journal-title":"Eur Heart J"},{"key":"10.1016\/j.medcli.2025.107247_bib0185","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1016\/S0140-6736(22)02076-1","article-title":"Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial","volume":"400","author":"Mebazaa","year":"2022","journal-title":"Lancet"},{"key":"10.1016\/j.medcli.2025.107247_bib0190","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/j.jchf.2024.03.001","article-title":"Eligibility and projected benefits of rapid initiation of quadruple medical therapy for newly diagnosed heart failure","volume":"12","author":"Greene","year":"2024","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.medcli.2025.107247_bib0195","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jchf.2018.06.011","article-title":"Initiation, continuation, switching, and withdrawal of heart failure medical therapies during hospitalization","volume":"7","author":"Bhagat","year":"2019","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.medcli.2025.107247_bib0200","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0140-6736(20)30748-0","article-title":"Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomised controlled trials","volume":"396","author":"Vaduganathan","year":"2020","journal-title":"Lancet"},{"key":"10.1016\/j.medcli.2025.107247_bib0205","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.jacc.2021.05.002","article-title":"Kidney function and outcomes in patients hospitalized with heart failure","volume":"78","author":"Patel","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.medcli.2025.107247_bib0210","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1056\/NEJMoa1409077","article-title":"Angiotensin\u2013neprilysin inhibition versus enalapril in heart failure","volume":"371","author":"McMurray","year":"2014","journal-title":"N Engl J Med"},{"key":"10.1016\/j.medcli.2025.107247_bib0215","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.jchf.2021.09.004","article-title":"A systematic review and network meta-analysis of pharmacological treatment of heart failure with reduced ejection fraction","volume":"10","author":"Tromp","year":"2022","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.medcli.2025.107247_bib0220","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1016\/j.jacc.2019.08.001","article-title":"2019 ACC expert consensus decision pathway on risk assessment, management, and clinical trajectory of patients hospitalized with heart failure","volume":"74","author":"Hollenberg","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.medcli.2025.107247_bib0225","first-page":"511","article-title":"Sequencing quadruple therapy for heart failure with reduced ejection fraction: does it really matter?","volume":"41","author":"Hu","year":"2023","journal-title":"Cardiol Clin"},{"key":"10.1016\/j.medcli.2025.107247_bib0230","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/j.cardfail.2021.04.004","article-title":"Hospitalization of patients with (but not for) heart failure: an opportunity for accelerated guideline-directed medical therapy optimization?","volume":"27","author":"Varshney","year":"2021","journal-title":"J Card Fail"},{"key":"10.1016\/j.medcli.2025.107247_bib0235","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/j.jchf.2022.10.013","article-title":"Patient eligibility for established and novel guideline-directed medical therapies after acute heart failure hospitalization","volume":"11","author":"Moghaddam","year":"2023","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.medcli.2025.107247_bib0240","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.jacc.2018.04.070","article-title":"Medical therapy for heart failure with reduced ejection fraction: the CHAMP-HF registry","volume":"72","author":"Greene","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.medcli.2025.107247_bib0245","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/j.jchf.2024.03.001","article-title":"Eligibility and projected benefits of rapid initiation of quadruple therapy for newly diagnosed heart failure","volume":"12","author":"Greene","year":"2024","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.medcli.2025.107247_bib0250","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.recesp.2016.06.010","article-title":"Classification and quality standards of heart failure units: scientific consensus of the Spanish Society of Cardiology","volume":"69","author":"Anguita S\u00e1nchez","year":"2016","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"issue":"suppl 3","key":"10.1016\/j.medcli.2025.107247_bib0255","first-page":"15","article-title":"Disease management programs in heart failure. Findings of the DIAL study","volume":"60","author":"Grancelli","year":"2007","journal-title":"Rev Esp Cardiol"},{"key":"10.1016\/j.medcli.2025.107247_bib0260","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.ejheart.2003.11.023","article-title":"Multicenter randomized trial of a comprehensive hospital discharge and outpatient heart failure management program","volume":"6","author":"Atienza","year":"2004","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.medcli.2025.107247_bib0265","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/S0002-9149(96)00676-5","article-title":"A comprehensive management system for heart failure improves clinical outcomes and reduces medical resource utilization","volume":"79","author":"West","year":"1997","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.medcli.2025.107247_bib0270","doi-asserted-by":"crossref","first-page":"1680","DOI":"10.1016\/j.jacc.2023.02.029","article-title":"Virtual care team guided management of patients with heart failure during hospitalization","volume":"81","author":"Bhatt","year":"2023","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.medcli.2025.107247_bib0275","doi-asserted-by":"crossref","DOI":"10.1186\/s12872-024-03728-y","article-title":"Annual evolution of the prescription of drugs with prognostic implications in acute decompensated heart failure with reduced ejection fraction","volume":"24","author":"L\u00f3pez-Vilella","year":"2024","journal-title":"BMC Cardiovasc Disord"},{"key":"10.1016\/j.medcli.2025.107247_bib0280","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1016\/j.jacc.2024.02.009","article-title":"Efficacy and safety of dapagliflozin in patients with acute heart failure","volume":"83","author":"Cox","year":"2024","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.medcli.2025.107247_bib0285","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1038\/s41591-021-01659-1","article-title":"The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial","volume":"28","author":"Voors","year":"2022","journal-title":"Nat Med"},{"key":"10.1016\/j.medcli.2025.107247_bib0290","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1161\/CIRCULATIONAHA.121.052792","article-title":"Evidence-based medical therapy in patients with heart failure with reduced ejection fraction and chronic kidney disease","volume":"145","author":"Beldhuis","year":"2022","journal-title":"Circulation"},{"key":"10.1016\/j.medcli.2025.107247_bib0295","doi-asserted-by":"crossref","first-page":"855","DOI":"10.2147\/CLEP.S412787","article-title":"Initiation of medical therapy for heart failure patients according to kidney function: a Danish nationwide study","volume":"15","author":"Zahir Anjum","year":"2023","journal-title":"Clin Epidemiol"},{"key":"10.1016\/j.medcli.2025.107247_bib0300","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1002\/ehf2.13118","article-title":"Congestive nephropathy: a neglected entity? Proposal for diagnostic criteria and future perspectives","volume":"8","author":"Husain-Syed","year":"2021","journal-title":"ESC Heart Fail"}],"container-title":["Medicina Cl\u00ednica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0025775325004750?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0025775325004750?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T14:11:38Z","timestamp":1771942298000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0025775325004750"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["S0025775325004750"],"URL":"https:\/\/doi.org\/10.1016\/j.medcli.2025.107247","relation":{},"ISSN":["0025-7753"],"issn-type":[{"value":"0025-7753","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Initiation and titration of guideline-directed medical therapy during hospitalization for acute decompensation of heart failure with reduced ejection fraction","name":"articletitle","label":"Article Title"},{"value":"Medicina Cl\u00ednica","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.medcli.2025.107247","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Espa\u00f1a, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"107247"}}