Journal of the American Heart Association, Volume 15, Issue 6 , March 17, 2026. BackgroundGuideline‐directed medical therapy (GDMT) improves outcomes in heart failure irrespective of frailty status.
Nevertheless, the magnitude of frailty‐associated discontinuation of GDMT remains insufficiently studied. We aimed to quantify 12‐month discontinuation rates of GDMT across frailty strata.MethodsThis retrospective cohort study used a nationwide insurer‐based database.
We identified patients aged ≥65 years who were hospitalized for heart failure between 2014 and 2022 and newly initiated on at least 1 GDMT at discharge, including angiotensin‐converting enzyme inhibitors/angiotensin II receptor blockers/angiotensin receptor‐neprilysin inhibitors, β‐blockers, mineralocorticoid receptor antagonists, or SGLT2is (sodium‐glucose cotransporter‐2 inhibitors). Discontinuation was defined as a gap of 60 days without a prescription following the expected completion of the dispensed supply.
The cumulative incidence of GDMT discontinuation within 12 months was estimated according to Hospital Frailty Risk Score, with death treated as a competing risk.ResultsWe analyzed 33 155 patients (mean age: 83.2 years, women: 53.0%).
Journal of the American Heart Association published a clinical update in Cardiology on 13 Mar 2026.
The item focuses on Discontinuation of Heart Failure Pharmacotherapy in Older Adults With Frailty.
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