Utility of a heart failure treatment score (quad score) in predicting early outcomes in patients with heart failure and a reduced ejection fraction

Introduction: International guidelines recommend that the four pillars of heart failure drug therapy including an Angiotensin Converting Enzyme Inhibitor (ACEi) or Angiotensin Receptor Neprilysin Inhibitor (ARNI), Betablocker (BB), Mineralocorticoid Receptor Antagonist (MRA) and Sodium Glucose co-transporter II inhibitor (SGLT2i) are prescribed to patients with heart failure and a reduced ejection fraction (HFrEF) to improve symptoms and prognosis. The greatest benefit is derived with additional drug classes prescribed and at optimum dosing. Despite this, treatment inertia remains a recognized limitation to heart failure drug optimization and is associated with poor outcomes.