{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T21:48:28Z","timestamp":1776289708181,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Israeli Center for Cardiovascular Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Guideline-directed medical therapies for heart failure (HF) may benefit patients with reduced left ventricular ejection fraction (LVEF) following acute coronary syndromes (ACS). Few real-world data are available regarding the early implementation of HF therapies in patients with ACS and reduced LVEF. Methods: Data collected from the 2021 nationwide, prospective ACS Israeli Survey (ACSIS). Drug classes included: (a) angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB) or angiotensin receptor-neprilysin inhibitors (ARNI); (b) beta-blockers; (c) mineralocorticoid receptor antagonist (MRA) and (d) sodium-glucose cotransporter-2 inhibitors (SGLT2I). The utilization of HF therapies at discharge or 90 days following ACS was analyzed in relation to LVEF [reduced \u226440% (n = 406) or mildly-reduced 41\u201349% (n = 255)] and short-term adverse outcomes. Results: History of HF, anterior wall myocardial infarction and Killip class II-IV (32% vs. 14% p &lt; 0.001) were more prevalent in those with reduced compared to mildly-reduced LVEF. ACEI\/ARB\/ARNI and beta-blockers were used by the majority of patients in both LVEF groups, though ARNI was prescribed to only 3.9% (LVEF \u2264 40%). MRA was used by 42.9% and 12.2% of patients with LVEF \u226440% and 41\u201349%, respectively, and SGLT2I in about a quarter of both LVEF groups. Overall, \u22653 HF drug classes were documented in 44% of the patients. A trend towards higher rates of 90-day HF rehospitalizations, recurrent ACS or all-cause death was noted in those with reduced (7.6%) vs. mildly-reduced (3.7%) LVEF, p = 0.084. No association was observed between the number of HF drug classes or the use of ARNI and\/or SGLT2I with adverse clinical outcomes. Conclusions: In current clinical practice, the majority of patients with reduced and mildly-reduced LVEF are treated by ACEI\/ARB and beta-blockers early following ACS, whereas MRA is underutilized and the adoption of SGLT2I and ARNI is low. A greater number of therapeutic classes was not associated with reduced short-term rehospitalizations or mortality.<\/jats:p>","DOI":"10.3390\/jpm13061015","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T01:37:38Z","timestamp":1687225058000},"page":"1015","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Heart Failure Therapies following Acute Coronary Syndromes with Reduced Ejection Fraction: Data from the ACSIS Survey"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2391-8397","authenticated-orcid":false,"given":"Barak","family":"Zafrir","sequence":"first","affiliation":[{"name":"Lady Davis Carmel Medical Center, Cardiology Department, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 7 Michal St., Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tal","family":"Ovdat","sequence":"additional","affiliation":[{"name":"Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmood","family":"Abu Akel","sequence":"additional","affiliation":[{"name":"Lady Davis Carmel Medical Center, Cardiology Department, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 7 Michal St., Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadel","family":"Bahouth","sequence":"additional","affiliation":[{"name":"Cardiology Department, Bnai Zion Medical Center, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katia","family":"Orvin","sequence":"additional","affiliation":[{"name":"Rabin Medical Center, Cardiology Department, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy","family":"Beigel","sequence":"additional","affiliation":[{"name":"Leviev Heart Center, Sheba Medical Center, Cardiovascular Division, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Offer","family":"Amir","sequence":"additional","affiliation":[{"name":"Hadassah Medical Center, Faculty of Medicine, Heart Institute, Hebrew University of Jerusalem, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1922-9174","authenticated-orcid":false,"given":"Gabby","family":"Elbaz-Greener","sequence":"additional","affiliation":[{"name":"Hadassah Medical Center, Faculty of Medicine, Heart Institute, Hebrew University of Jerusalem, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1056\/NEJMcp0909392","article-title":"Clinical practice. 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