{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:05:15Z","timestamp":1793196315870,"version":"4.5.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,12,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Significant gap remains in the implementation of guideline\u2010directed medical therapy (GDMT) in patients with heart failure after a hospitalization. We aimed to evaluate the use and titration of GDMT at discharge and over a 12\u2010month period after hospital discharge and to identify factors associated with GDMT use and titration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">The CONNECT\u2010HF (Care Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure) trial evaluated the effect of a hospital and postdischarge quality improvement intervention in participants with heart failure with reduced ejection fraction. In this secondary analysis, we examined use and titration to at least 50% of the target dose of GDMTs at hospital discharge and over time. Among 4646 participants (mean age 63\u2009years, 34% women), GDMT use did not numerically improve from discharge to 12 months: beta blockers (84%\u201378%), angiotensin\u2010converting enzyme inhibitors\/angiotensin II receptor blockers\/angiotensin receptor\u2010neprilysin inhibitors (73%\u201365%), mineralocorticoid receptor antagonists (39%\u201336%), and sodium\u2010glucose cotransporter 2 inhibitors (1.5%\u20132.1%). Achieving \u226550% of the target dose also showed little change over 12 months: beta blockers (35%\u201332%), angiotensin\u2010converting enzyme inhibitors\/angiotensin II receptor blockers\/angiotensin receptor\u2010neprilysin inhibitors (28%\u201325%). For all medications, use of GDMT at discharge was associated with the use and achieving \u226550% of the target dose at 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Following a hospitalization for heart failure, GDMT use remained low and did not numerically improve over 12 months. Use of GDMT at discharge was significantly associated with the use of GDMT over time, highlighting the importance of initiating GDMT during hospitalization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.036998","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T07:16:53Z","timestamp":1733815013000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Guideline\u2010Directed Medical Therapy After Hospitalization for Acute Heart Failure: Insights From the CONNECT\u2010HF"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2223-7215","authenticated-orcid":false,"given":"Satoshi","family":"Shoji","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute Durham NC USA"},{"name":"Division of Cardiology and Department of Medicine Duke University School of Medicine Durham NC USA"},{"name":"Department of Cardiology Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Kaltenbach","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0828-6851","authenticated-orcid":false,"given":"Bradi B.","family":"Granger","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing and Duke\u2010Margolis Health Policy Institute Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3192-8093","authenticated-orcid":false,"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1375-0487","authenticated-orcid":false,"given":"Hussein R.","family":"Al\u2010Khalidi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3619-966X","authenticated-orcid":false,"given":"Nancy M.","family":"Albert","sequence":"additional","affiliation":[{"name":"Nursing Institute and Heart, Vascular and Thoracic Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7683-4720","authenticated-orcid":false,"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Research Institute, Dallas TX and University of Mississippi Jackson MS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-3095","authenticated-orcid":false,"given":"Larry A.","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Colorado School of Medicine Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6471-1483","authenticated-orcid":false,"given":"David E.","family":"Lanfear","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine, Henry Ford Hospital Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9131-685X","authenticated-orcid":false,"given":"Jennifer T.","family":"Thibodeau","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany M.","family":"Chapman","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5705-0963","authenticated-orcid":false,"given":"Sandra M.","family":"Oliver\u2010McNeil","sequence":"additional","affiliation":[{"name":"College of Nursing Wayne State University Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5931-1239","authenticated-orcid":false,"given":"G. 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