†These authors contributed equally.
Background: Although compliance with the guideline recommendations for
heart failure (HF) is associated with improved survival, the effects of
medication on clinical practice often fail to meet expectations due to physician
and/or patient-related reasons that are unclear. This study analyzed physicians’
compliance with guideline-directed medical therapy (GDMT) based on real-world
clinical data and identified risk factors of low compliance. Methods:
This study included patients with HF, who were treated at the Affiliated Hospital
of North Sichuan Medical College from July 2017 to June 2021. All patients were
divided into high compliance, moderate compliance, and low compliance with GDMT
groups. The proportion of patients receiving treatment in compliance with GDMT
was analyzed, the relationship between compliance with GDMT and clinical outcomes
was evaluated, and the risk factors of low compliance were identified.
Results: Of all patients with HF included in the study, 498 (23.8%) had
low compliance with GDMT, 1413 (67.4%) had moderate compliance with GDMT, and
185 (8.8%) had high compliance with GDMT. The readmission rate of patients in
the moderate compliance with GDMT group was significantly higher than that in the
high and low compliance groups (p = 0.028). There were no significant
differences in the rates of severe cardiovascular disease among the three groups.
The mortality rate of patients in the high compliance with GDMT group was
significantly higher than that of the other groups (p
