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December 19, 2025Open Access

Association of poor adherence to guideline-directed medical treatment with adverse events including fatal arrhythmia in heart failure with reduced ejection fraction: A nationwide cohort analysis

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Authors

MKMoojun KimDCDong‐Hyuk ChoJCJimi Choi

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Overview

Cohort analysis shows poor GDMT adherence increases risk of sudden cardiac death and arrhythmias in heart failure patients.

Key Points

  • This research aims to assess the impact of adherence to guideline-directed medical therapy on adverse outcomes in heart failure patients.
  • Analyzed data from patients with implantable cardioverter-defibrillator or cardiac resynchronization therapy for primary prevention.
  • Excluded patients with previous sustained ventricular tachycardia or ventricular fibrillation.
  • Categorized adherence to renin-angiotensin system blockers, beta blockers, and mineralocorticoid receptor antagonists as optimal, suboptimal, or poor.
  • Documented 87.5% adherence to RASBs, 89.7% to BBs, and 74.2% to MRAs among 3,780 patients.
  • Both suboptimal and poor adherence linked to higher risk of adverse outcomes compared to optimal adherence.
  • Relationships between adherence and arrhythmic events were inconsistent; however, poorer adherence led to higher mortality.

Cite This Study

Kim et al. (2025) studied this question.

synapsesocial.com/papers/69449a892f0218eca95083f3https://doi.org/10.64898/2025.12.15.25342327
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  1. 1Prophylactic Implantation of a Defibrillator in Patients with Myocardial Infarction and Reduced Ejection Fraction2002 · 6,923 citations