What is guideline directed medical therapy?

GDMT refers to initial medical therapy with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin-receptor blockers (ARB), beta-blockers (BB), and mineralocorticoid receptor antagonists (MRA) titrating to maximally tolerated doses for patients with HFrEF.

What is GDMT for CAD?

We defined GDMT for the treatment of CAD and HFrEF as the combination of at least one antiplatelet drug, a statin, a beta-blocker, and an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. The primary outcome was all-cause mortality.

What does GDMT stand for?

GDMT, which stands for guideline-directed medical therapy.

What are the goals of therapy for HFrEF?

The goals of therapy of HFrEF are to reduce morbidity (ie, reduce symptoms, improve health-related quality of life and functional status, and decrease the rate of hospitalization), and to reduce mortality.

What is stable CAD?

Stable coronary artery disease (CAD) refers to a reversible supply/demand mismatch related to ischemia, a history of myocardial infarction (MI), or the presence of plaque documented by catheterization or computed tomography angiography.

What is a CRT in the medical field?

Cardiac resynchronization therapy (CRT) is treatment to help your heart beat with the right rhythm. It uses a pacemaker to restore the normal timing pattern of the heartbeat. The CRT pacemaker coordinates how timing of the upper heart chambers (atria) and the lower heart chambers (ventricles).

What is medical HFrEF?

In HF with reduced ejection fraction (HFrEF), also known as systolic HF, the heart muscle is not able to contract adequately and, therefore, expels less oxygen-rich blood into the body. Patients with this form of the disease will have lower-than-normal left ventricular ejection fraction on an echocardiogram.

Is HFrEF diastolic or systolic?

]. Nowadays, diastolic heart failure is referred to as heart failure with preserved ejection fraction (HFpEF), whereas systolic heart failure is referred to as heart failure with reduced ejection fraction (HFrEF).

How to treat HFpEF?

Patients with HFpEF and symptoms and signs of ischemia are treated with standard therapy including beta blockers and calcium channel blockers. Nitrates are often prescribed, but the reduction in preload can lead to hypotension in some patients [ 11 ]. (See “Chronic coronary syndrome: Overview of care” .)

What is goal directed therapy?

Early goal-directed therapy. Early goal-directed therapy was introduced by Emanuel P. Rivers in The New England Journal of Medicine in 2001 and is a technique used in critical care medicine involving intensive monitoring and aggressive management of perioperative hemodynamics in patients with a high risk of morbidity and mortality.

Does Medi Cal cover therapy?

Program Coverage Medi-Cal covers physical therapy services when ordered on the written prescription of a physician, dentist or podiatrist and rendered by a Medi-Cal provider. Physical therapy services include physical therapy evaluation, treatment planning, treatment, instruction, consultations and application of topical medication.