695 PRESCRIBING A COMPREHENSIVE THERAPY WITH THE FOUR FOUNDATIONAL TREATMENTS OF HEART FAILURE WITH REDUCED EJECTION FRACTION AMONG IN-PATIENTS AT DISCHARGE

Abstract Background Current guidelines recommend that patients with heart failure and a reduced ejection fraction (HFrEF) should receive four foundational treatments, i.e. renin-angiotensin system inhibitor (RASi) or angiotensin-receptor neprilysin (ARNi), β-blocker, mineralocorticoid receptor antagonist (MRA) sodium-glucose cotransporter 2 (SGLT2i). There is emerging consensus simultaneous initiation rapid sequencing provide greater benefit, enhancing tolerability of these therapies improving outcomes. However, implementation comprehensive approach limited by common underuse underdosing, paucity data exists on initiating the pharmacological pillars HFrEF during hospitalization at discharge. Aim To investigate feasibility in discharge after an episode (HF) tertiary referral center. Methods In-patients first HF (2019-2021) were categorized according to number/type treatments prescribed Prevalence contraindications cautions for – as defined current European Society Cardiology (ESC) was assessed. Logistic regression models fitted assess predictors number risk re-hospitalization. Results Among 305 HFrEF, 49.2% received least two recommended drugs. A β-blocker 93.4% patients, RASi/ARNi 68.2%. Based recommendations, 46.2% could An MRA 32.5% 100% did not show use. Renal dysfunction present 13.1% while hypotension 11.8%. Bradycardia renal associated lower drugs [adjusted OR (95% CI) 0.18 (0.06-0.50), 0.50 (0.39-0.64), respectively]. higher used no rehospitalization 30 days [OR 0.22 (0.10-0.49) per increase]. Conclusions presence/absence contraindications, quadruple therapy be implementable contemporary cohort in-patients bradycardia main prevalent conditions limiting achievement more therapeutic approach. Use re-hospitalization within