{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:30:36Z","timestamp":1790890236057,"version":"4.1.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T00:00:00Z","timestamp":1581984000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100008272","name":"Novartis Pharmaceuticals Corporation","doi-asserted-by":"crossref","award":["CLCZ6969BKW01T"],"award-info":[{"award-number":["CLCZ6969BKW01T"]}],"id":[{"id":"10.13039\/100008272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Angiology"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>We describe the characteristics of ambulatory patients with heart failure with reduced ejection fraction (HFrEF) in the Gulf region (Middle East) and the implementation of guideline-recommended treatments. We included 2427 HFrEF outpatients (mean age 59 \u00b1 13 years, 75% males and median left ventricular ejection fraction [LVEF] of 30%). A high proportion of patients received guideline-recommended medications (angiotensin-converting enzyme inhibitor [ACEI]\/angiotensin receptor blocker [ARB]\/angiotensin receptor-neprilysin inhibitor [ARNI] 87%, \u03b2-blocker 91%, mineralocorticoid antagonist [MRA] 64%). However, only a minority of patients received guideline-recommended target doses (ACEI\/ARB\/ARNI 13%, \u03b2-blocker 27%, and MRA 4.4%). Old age was a significant independent predictor for not prescribing treatment ( P &lt; .001 for ACEI\/ARB\/ARNI and MRA; and P = .002 for \u03b2-blockers). Other independent predictors were chronic kidney disease (for both ACEI\/ARB\/ARNI and MRA, P &lt; .001) and higher LVEF ( P = .014 for \u03b2-blockers and P &lt; .001 for MRA). Patients with HFrEF managed by heart failure specialists more often received recommended target doses of ACEI\/ARB\/ARNI (40% vs 11%, P &lt; .001) and \u03b2-blockers (56% vs 26%, P &lt; .001) compared to those treated by general cardiologists. Although the majority of our patients with HFrEF received guideline-recommended medications, the doses they were prescribed were suboptimal. Understanding the reasons behind this is important for improved practice.<\/jats:p>","DOI":"10.1177\/0003319720905742","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T04:39:12Z","timestamp":1582000752000},"page":"431-437","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Implementation of Guideline-Recommended Therapies for Patients With Heart Failure and Reduced Ejection Fraction: A Regional Arab Middle East Experience"],"prefix":"10.1177","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4588-3292","authenticated-orcid":false,"given":"Mohammad","family":"Zubaid","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Medicine, Kuwait University, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafa","family":"Rashed","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mubarak Al-Kabeer Hospital, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Ridha","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Al Dabbous Cardiac Centre, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nooshin","family":"Bazargani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel","family":"Hamad","sequence":"additional","affiliation":[{"name":"Mohammed bin Salman Al Khalifa Cardiac Centre, Bahrain Defense Force Hospital, Manama, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashed Al","family":"Banna","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Salmaniya Medical Complex, Manama, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidal","family":"Asaad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kadhim","family":"Sulaiman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Hospital, Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Al-Jarallah","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sabah Al-Ahmed Cardiac Center, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif Al","family":"Mulla","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiac Sciences Institute, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Baslaib","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rashid Hospital, Dubai, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael","family":"AlMahmeed","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab 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