Hasanah, Dian Yaniarti
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2023 Indonesian Guidelines for Heart Failure Treatment: Working Group on Heart Failure and Cardiometabolic Diseases, Indonesian Heart Association Hasanah, Dian Yaniarti; Zulkarnain, Edrian; Arifianto, Habibie; Prameswari, Hawani Sasmaya; Suciadi, Leonardo Paskah; Yamin, Paskariatne Probo Dewi; Pratikto, Rarsari Soerarso; Nauli, Siti Elkana; Putri, Vebiona Kartini Prima; Soedarsono, Wahyu Aditya; Sarastri, Yuke
Jurnal Kardiologi Indonesia Vol 45 No 2 (2024): April - June, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1671

Abstract

Heart failure is a health problem with high mortality and morbidity rates in developed and developing countries such as Indonesia. The prevalence of heart failure itself is increasing because patients who experience acute heart failure can progress to chronic heart failure. Guidelines-Directed Medical Therapy (GDMT) with recommended doses is still underutilized in heart failure patients with reduced ejection fraction (HFrEF). In Indonesia itself, even though it has a fairly high rate of use of ACE-inhibitors (ACE-I) or angiotensin receptor blockers (ARB), Indonesia has the lowest rate of use of β-blockers and aldosterone inhibitors (also called Mineralocorticoid Receptor Antagonists, MRA) of the entire ASIAN-HF registry.84 Therefore, the writing of this guideline was carried out as an effort to provide practical guidance regarding the diagnosis, assessment and management of acute and chronic heart failure. Thus, it is hoped that efforts can be made to prevent the increase in prevalence and reduce the number of rehospitalization with complete management. This book was written as an update to the 2020 Guideline for the Management of Heart Failure: Indonesian Heart Association. The sources of our updates came from many references and literatures carried out by each contributor and reviewed by EBM team.
Improving patient outcomes : The pivotal role of guideline directed medical treatment Hasanah, Dian Yaniarti
Heart Science Journal Vol. 7 No. 2 (2026): The Evolving Landscape of Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.02.1

Abstract

Guideline directed medical therapy (GDMT) continues as the main pillar of management for heart failure with reduced ejection fraction (HFrEF). Numerous positive landmark trials and emergence of novel drugs provide strong evidence supporting the capability of GDMT in reducing cardiovascular mortality, hospitalization due to heart failure (HHF), and advancement of renal impairment. The introduction of a four-pill regimen comprising five specific pharmacological agents represents a major shift in disease-modifying care, significantly slowing symptomatic decline and improving long-term survival outcomes. Despite strong clinical recommendation, there is a huge gaps in the implementation of clinically-proven pharmacological strategies for eligible patients that further linked to relatively persistently flat mortality curves of HfrEF patients. Effective adherence to HF guidelines is often hindered by a multifaceted interplay of patient-related hurdles, clinical inertia, and systemic healthcare limitations. These challenges are further compounded by age-related complexities and multimorbidity, where concerns over pill burden and inadequate disease literacy frequently lead to suboptimal therapeutic outcomes.