{
  "abstract": "Background: While guideline-directed medical therapy (GDMT) is recommended for left ventricular assist device (LVAD) recipients, real-world evidence supporting its clinical impact remains limited. This study evaluated the association between GDMT prescription and clinical outcomes in LVAD patients. Methods: This international retrospective multicenter study included 875 LVAD patients from 22 centers. Patients were categorized based on the number of GDMT (ACE-I/ARBs, beta-blockers, MRAs) prescribed. Primary outcome was 6-month all-cause mortality. Secondary outcome was late ventricular arrhythmias (VAs) (>30 days post-implant). Multivariable Cox regression and ordinal logistic regression analyses were performed. Results: Overall, only 261 patients (29.8%) received triple GDMT, while 97 (11.1%) received no GDMT. After multivariable adjustment, the number of prescribed GDMTs was independently associated with improved survival, with aHRs for all-cause mortality of 0.51 (0.33-0.75, p<0.01) for triple therapy, 0.39 (0.26-0.59, p<0.01) for dual therapy, and 0.45 (0.30-0.67, p<0.01) for single therapy, all compared with no GDMT. Similarly, ACE-I/ARB were associated with a lower risk of late VAs (aHR 0.65 [0.50-0.84], p<0.01). Female sex, diabetes, early VAs, and higher bilirubin levels were associated with lower GDMT prescription rates. Major LVEDD improvement (≥10mm reduction) increased progressively from 51.5% without GDMT to 66.1% with triple therapy. Conclusion: In this large international study, the use of GDMT in LVAD patients was associated with improved survival, with benefits observed even with single-agent therapy. Despite these benefits, only 30% of patients received optimal triple therapy, highlighting the need for improved implementation strategies and standardized protocols in this population.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 33,
  "authors": [
    {
      "name": "Miloud Cherbi"
    },
    {
      "name": "Clément Delmas"
    },
    {
      "name": "Paul Gautier"
    },
    {
      "name": "Karim Benali"
    },
    {
      "name": "Kerstin Bode"
    },
    {
      "name": "Elena Efimova"
    },
    {
      "name": "Alexey Dashkevich"
    },
    {
      "name": "Jackson J. Liang"
    },
    {
      "name": "John Larson"
    },
    {
      "name": "Blandine Mondésert"
    },
    {
      "name": "Jacinthe Boulet"
    },
    {
      "name": "Pierre-Emmanuel Noly"
    },
    {
      "name": "François Picard"
    },
    {
      "name": "Jean-Luc Pasquié"
    },
    {
      "name": "Jean-Baptiste Gourraud"
    },
    {
      "name": "Sandro Ninni"
    },
    {
      "name": "Laurence Jesel-Morel"
    },
    {
      "name": "Alexandre Sebestyen"
    },
    {
      "name": "Marylou Para"
    },
    {
      "name": "Jean-Claude Deharo"
    },
    {
      "name": "Frédéric Anselme"
    },
    {
      "name": "Laure Champ-Rigot"
    },
    {
      "name": "Soundous M’rabet"
    },
    {
      "name": "Bertrand Pierre"
    },
    {
      "name": "Romain Eschalier"
    },
    {
      "name": "Mathieu Echivard"
    },
    {
      "name": "Anne-Céline Martin"
    },
    {
      "name": "Nicolas Lellouche"
    },
    {
      "name": "Matteo Pozzi"
    },
    {
      "name": "Pierre Groussin"
    },
    {
      "name": "Erwan Flécher"
    },
    {
      "name": "Vincent Galand"
    },
    {
      "name": "Raphaël P Martins"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d8n1v6pj889fa.bib",
  "cited_by": 0,
  "doi": "10.1093/eschf/xvag174",
  "fulltext_url": null,
  "id": "d8n1v6pj889fa",
  "issns": [
    "2055-5822"
  ],
  "landing_url": "https://hal.science/hal-05674207v1",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "openalex",
      "2204|Mechanical Circulatory Support Devices"
    ]
  ],
  "openalex": "W7165543534",
  "pdf_url": "https://hal.science/hal-05674207/document",
  "pmcid": null,
  "pmid": "42325168",
  "published": "2026-06-22",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/d8n1v6pj889fa.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:56Z",
      "native_id": "hal-05674207",
      "source": "hal",
      "url": "https://hal.science/hal-05674207v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2705|Heart Failure Treatment and Management",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Clinical Impact of Guideline-Directed Medical Therapy in Patients with Left Ventricular Assist Device: An International Multicenter Study",
  "title_text": "Clinical Impact of Guideline-Directed Medical Therapy in Patients with Left Ventricular Assist Device: An International Multicenter Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:56Z",
  "url": "https://research.draconitic.com/paper/d8n1v6pj889fa",
  "venue": "ESC Heart Failure",
  "versions": []
}