{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T23:29:29Z","timestamp":1776727769472,"version":"3.51.2"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Acute heart failure (AHF) is a leading cause of frequent hospitalizations and poor outcomes. While chronic HF is treated with guideline-directed medical therapy, acute hospital care often requires loop diuretics, vasodilators, inotropes, and vasopressors. This study aimed to evaluate the inpatient use, dosing, and determinants of guideline-recommended therapies in patients hospitalized with AHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This nationwide, register-based cohort study included 6009 patients aged \u226545 years hospitalized with AHF with a left ventricular ejection fraction (LVEF) of \u226440% in Denmark from 2018 to 2023. Data from the Danish Heart Failure Registry were linked to national healthcare registers. The main outcomes were inpatient use and doses of loop diuretics, vasodilators, inotropes, and vasopressors. Loop diuretics were used in 88.7% of patients [median dose (MD) of furosemide: 50\u2005mg parenteral, 40\u2005mg oral]. Vasodilators were administered to 36.1% (MD of nitroglycerine: 30\u2005mg parenteral, 7.5\u2005mg oral). Inotropes were administered to 3.0%, including dopamine (0.5%), dobutamine (1.0%), milrinone (0.9%), and levosimendan (1.1%). Vasopressors were used in 8.4%, with norepinephrine (7.3%) and epinephrine (2.0%). Older patients (\u226575) had lower prevalence of vasodilator, inotrope, and vasopressor use. Severe HF (LVEF &amp;lt; 25%) was associated with lower prevalence of vasodilator and vasopressor use. In contrast, chronic kidney disease and recurrent HF hospitalization were linked to higher prevalence of use of all AHF therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Loop diuretics were widely used, while vasodilators, inotropes, and vasopressors had lower utilization. The observed variation in treatment reflects complexity of inpatient AHF management, warranting further studies to assess treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuaf156","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T12:56:10Z","timestamp":1764075370000},"page":"197-205","source":"Crossref","is-referenced-by-count":0,"title":["Utilization patterns and determinants of guideline-recommended therapies for acute heart failure in Denmark"],"prefix":"10.1093","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8073-3586","authenticated-orcid":false,"given":"George Frederick","family":"Mkoma","sequence":"first","affiliation":[{"name":"Department of Epidemiology Research, Statens Serum Institut , Artillerivej 5, 2300 Copenhagen ,","place":["Denmark"]},{"name":"Section of Health Services Research, Department of Public Health, University of Copenhagen , \u00d8ster Farimagsgade 5B, 1014 Copenhagen ,","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7509-9127","authenticated-orcid":false,"given":"Anders","family":"Hviid","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Research, Statens Serum Institut , Artillerivej 5, 2300 Copenhagen ,","place":["Denmark"]},{"name":"Pharmacovigilance Research Center, Department of Drug Design and Pharmacology, University of Copenhagen , Universitetsparken 2, 2100 Copenhagen ,","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2097-8466","authenticated-orcid":false,"given":"Bj\u00f6rn","family":"Pasternak","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Research, Statens Serum Institut , Artillerivej 5, 2300 Copenhagen ,","place":["Denmark"]},{"name":"Centre for Pharmacoepidemiology, Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet , K2 Medicin Solna, 17177 Stockholm ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1015-7215","authenticated-orcid":false,"given":"Henrik","family":"Svanstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Research, Statens Serum Institut , Artillerivej 5, 2300 Copenhagen ,","place":["Denmark"]},{"name":"Centre for Pharmacoepidemiology, Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet , K2 Medicin Solna, 17177 Stockholm ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"2026042007521136100_zuaf156-B1","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: a comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc Res"},{"key":"2026042007521136100_zuaf156-B2","doi-asserted-by":"crossref","first-page":"2767","DOI":"10.1002\/ehf2.14076","article-title":"Impact analysis of heart failure across European countries: an ESC-HFA position paper","volume":"9","author":"Rosano","year":"2022","journal-title":"ESC Heart Fail"},{"key":"2026042007521136100_zuaf156-B3"},{"key":"2026042007521136100_zuaf156-B4","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":"2026042007521136100_zuaf156-B5","first-page":"e895","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"2026042007521136100_zuaf156-B6"},{"key":"2026042007521136100_zuaf156-B7","doi-asserted-by":"crossref","first-page":"e002531","DOI":"10.1161\/JAHA.115.002531","article-title":"Impact of nitrate use on survival in acute heart failure: a propensity-matched analysis","volume":"5","author":"Ho","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"2026042007521136100_zuaf156-B8","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/S0195-668X(02)00700-5","article-title":"The EuroHeart failure survey programme\u2013a survey on the quality of care among patients with heart failure in Europe. 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