Comparison of Quadruple Therapy Sequencing Strategies for Heart Failure With Reduced Ejection Fraction.

ABSTRACT:

Background

Guidelines unanimously recommend quadruple therapy for patients with heart failure with reduced ejection fraction (HFrEF), yet direct comparative evidence is lacking to recommend a specific order of initiating and titrating these agents (or "sequencing strategy"). In the absence of randomized evidence, we aimed to compare the 1-year efficacy and harms of proposed HFrEF quadruple therapy sequencing strategies using a microsimulation model.

Methods

We conducted a microsimulation study to compare 6 different HFrEF medication sequencing strategies (emulating the range of conventional, 2-drug, and rapid or simultaneous strategies), each with 2 versions (twice-weekly/weekly medication adjustments), applied to treatment-naïve outpatients with HFrEF. We modeled death; tot

SUBMITTER: Turgeon RD 

PROVIDER: S-EPMC12554406 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature