Efficacy and safety of quadruple therapy versus triple therapy in patients with heart failure with preserved ejection fraction: a propensity score-matched real-world study - Report - MDSpire
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Comparative Analysis of Quadruple Therapy Versus Triple Therapy in Patients with Heart Failure and Preserved Ejection Fraction: A Real-World Study Utilizing Propensity Score Matching
Clinical Report: Comparative Analysis of Quadruple Therapy Versus Triple Therapy in HFpEF
Overview
This study evaluates the efficacy of quadruple therapy compared to triple therapy in patients with heart failure and preserved ejection fraction (HFpEF). Results indicate that quadruple therapy is associated with a lower incidence of heart failure hospitalization and cardiovascular death compared to triple therapy.
Background
Heart failure with preserved ejection fraction (HFpEF) is a prevalent condition, accounting for over 50% of heart failure cases globally. Despite the establishment of triple therapy as a foundational treatment, residual risk remains high, necessitating exploration of additional therapeutic strategies such as quadruple therapy.
Data Highlights
Group
Primary Endpoint Incidence
First Heart Failure Hospitalization
Recurrent Heart Failure Hospitalization
Quadruple Therapy
17.8%
14.4%
0.217 events/person-year
Triple Therapy
25.0%
20.6%
0.325 events/person-year
Key Findings
Quadruple therapy reduced the primary endpoint incidence compared to triple therapy (17.8% vs. 25.0%, P = 0.035).
First heart failure hospitalization rates were lower in the quadruple therapy group (14.4% vs. 20.6%, P = 0.030).
Recurrent heart failure hospitalization rates were also lower in the quadruple therapy group (0.217 vs. 0.325 events per person-year, P = 0.015).
Patients with concomitant coronary artery disease showed a greater benefit from quadruple therapy (HR = 0.591, P = 0.047).
Patients with baseline heart rate ≥70 beats per minute derived significant benefit from quadruple therapy (HR = 0.572, P = 0.045).
No significant difference in cardiovascular or all-cause mortality was observed between the two groups.
Clinical Implications
The findings indicate differences in heart failure hospitalization rates between quadruple and triple therapy in patients with HFpEF.
Conclusion
Quadruple therapy is associated with a lower incidence of heart failure hospitalization and cardiovascular death in patients with HFpEF compared to triple therapy. Further prospective studies are needed to validate these findings.
