{"id":"5cd0145d7434","type":"article","url":"https://hartvaat.nl/2026/12/31/richtlijntherapie-hartfalen-blijft-onderbenut-bij-patienten-met-hiv/","title":"Richtlijntherapie hartfalen blijft onderbenut bij patiënten met HIV","title_en":"Heart failure among people with HIV: prescription of guideline-directed medical therapy.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"HIV research & clinical practice","doi":"10.1080/25787489.2026.2728496","source_url":"https://doi.org/10.1080/25787489.2026.2728496","authors":["Melissa Klein Cutshaw","Robert Clare","Karen Chiswell","Paul Hofmann","April C Pettit","Eric Meissner","Matthew S Durstenfeld","Christopher T Longenecker","Gerald S Bloomfield","Nwora Lance Okeke"],"significance":4,"published":"2026-09-18","source_date":"2026-12-31","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hartfalen-polikliniek-opzet/","https://hartvaat.nl/kennis/hartfalen/palliatief-hartfalen/"],"congress":"","summary_en":"A retrospective cohort analysis of 451 patients with HIV and systolic heart failure evaluated the intensity of guideline-directed medical therapy (GDMT). The mean GDMT score was only 30%, with 85.8% receiving any therapy and 45.5% attending a cardiology clinic; higher scores were associated with diabetes, prior myocardial infarction, and specialist visits, while older age and renal disease correlated with lower scores. These findings highlight a significant care gap and underscore the need for structured multidisciplinary management to optimize GDMT adherence in HIV-positive patients with heart failure.","created":"2026-09-12T00:48:10Z","updated":"2026-09-12T00:48:10Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een retrospectieve cohortstudie onder 451 patiënten met HIV en systolisch hartfalen werd de intensiteit van de richtlijnmedicatie (GDMT) geëvalueerd. Het gemiddelde GDMT-score lag op slechts 30%, met 85,8% die enige therapie ontving en 45,5% die een cardiologisch spreekuur bezocht; hogere scores correleerden met diabetes, een eerder infarct en specialistisch consult, terwijl oudere leeftijd en nierinsufficiëntie met lagere scores gepaard gingen. Deze bevindingen onderstrepen een duidelijke zorgkloof en benadrukken de noodzaak van gestructureerde multidisciplinaire begeleiding om de GDMT-intensiteit in deze kwetsbare populatie te verhogen.","abstract_original":"BACKGROUND: People with HIV have an increased risk of heart failure (HF) compared to people without HIV. Guideline-directed medical therapy (GDMT) is the cornerstone of HF management, but little is known about GDMT prescription in this high-risk population. OBJECTIVE: To evaluate GDMT intensity and identify patient factors associated with optimal HF therapy among people with HIV and systolic HF. METHODS: We conducted retrospective analyses of the PATHWAYS study, a multi-institutional study of underrepresented racial and ethnic minorities with HIV. Adult patients with systolic HF (by ICD code) were included. A composite GDMT score was constructed using dosage-weighted prescription of GDMT drugs, ranging from 0% to 100% (with 100% indicating optimal therapy). RESULTS: Among 451 PWH with systolic HF, the median age was 54 years (IQR = 47-62), 34.6% were female, and 96.6% were Black. In the year after HF diagnosis, 85.8% of patients were prescribed any GDMT, and 45.5% of patients attended a cardiology clinic visit. The mean GDMT score was 30% (SD = 22%). In multivariable analyses, lower GDMT scores occurred among patients with older age (adjusted mean ratio [AMR] = 0.96, 95% CI: 0.93-0.99) and severe renal disease (AMR = 0.84, 95% CI: 0.71-0.99). Higher GDMT scores occurred among patients with diabetes mellitus (AMR = 1.33, 95% CI: 1.16-1.53), prior myocardial infarction (AMR = 1.17, 95% CI: 1.02-1.35), and those who attended a cardiology clinic visit (AMR = 1.29, 95% CI: 1.13-1.47). CONCLUSIONS: People with HIV and HF had low GDMT scores, suggesting suboptimal intensity of HF care. Cardiology clinic attendance was associated with higher GDMT scores."}