Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Changsha, 410011, Hunan Province, People's Republic of China.
Department of Metabolic Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan Province, People's Republic of China.
Am J Cardiovasc Drugs. 2024 May;24(3):329-342. doi: 10.1007/s40256-024-00646-4. Epub 2024 Apr 3.
The delayed titration of guideline-directed drug therapy (GDMT) is a complex event influenced by multiple factors that often result in poor prognosis for patients with heart failure (HF). Individualized adjustments in GDMT titration may be necessary based on patient characteristics, and every clinician is responsible for promptly initiating GDMT and titrating it appropriately within the patient's tolerance range. This review examines the current challenges in GDMT implementation and scrutinizes titration considerations within distinct subsets of HF patients, with the overarching goal of enhancing the adoption and effectiveness of GDMT. The authors also underscore the significance of establishing a novel management strategy that integrates cardiologists, nurse practitioners, pharmacists, and patients as a unified team that can contribute to the improved promotion and implementation of GDMT.
指南指导的药物治疗（GDMT）的延迟滴定是一个复杂的事件，受到多种因素的影响，这往往导致心力衰竭（HF）患者的预后不良。可能需要根据患者的特点对 GDMT 滴定进行个体化调整，每位临床医生都有责任及时启动 GDMT，并在患者耐受范围内适当滴定。这篇综述探讨了 GDMT 实施中的当前挑战，并仔细研究了 HF 患者不同亚组中的滴定考虑因素，其总体目标是提高 GDMT 的采用率和效果。作者还强调了建立一种新的管理策略的重要性，该策略将心脏病专家、执业护士、药剂师和患者整合为一个统一的团队，这有助于促进和实施 GDMT 的改进。
