ISSN: 1859 - 2872
Prevalence, associated factors, and short-term impact of the quadruple therapy in older patients with heart failure with reduced ejection fraction
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Abstract
Objective: To determine the prevalence and associated factors of quadruple therapy use in patients with heart failure with reduced ejection fraction (HFrEF) and to evaluate its impact on the first heart failure-related hospitalization within a 3-month follow-up among older outpatients. Subject and method: From September 2024 to April 2025, this longitudinal study enrolled patients aged ≥60 years with HFrEF at the cardiology outpatient clinics of Thong Nhat Hospital and the University Medical Center Ho Chi Minh City. Logistic regression was used to identify factors associated with quadruple therapy use, and Cox proportional hazards models were applied to assess its effect on time to first heart failure–related hospitalization. Result: A total of 285 older patients were included. The prevalence of quadruple therapy use was 49.5% (n = 141). Factors associated with lower odds of receiving quadruple therapy included age ≥75 years (OR 0.54; 95% CI 0.32–0.94; p=0.028) and chronic obstructive pulmonary disease (OR 0.23; 95% CI 0.08 - 0.68; p=0.007). The incidence of first-time heart failure–related hospitalization was significantly lower in the quadruple therapy group compared with the non–quadruple therapy group (HR 0.29; 95% CI 0.11 - 0.79; p=0.015). Conclusion: Only half of the older outpatients with HFrEF received the recommended quadruple therapy. Age ≥ 75 years and chronic obstructive pulmonary disease were significantly associated with reduced use of this regimen. Over a 3-month follow-up, quadruple therapy was associated with a substantial reduction in first-time heart failure–related hospitalizations.
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References
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