Sustained adherence to ESC guideline-recommended medications is associated with lower long-term mortality in heart failure and reduced ejection fraction: Insights from the EPICAL2 cohort.

As in all observational studies, our results may be affected by residual confounding related to unmeasured confounders, although we attempted to adjust for many confounders. Even a discontinuous prescription of the recommended drugs over time was associated with better long-term outcomes. In other words, whatever the time of HFrEF evolution, prescribing recommended drugs at some point was always better than never prescribing.