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In older patients, guideline‐directed medical therapy (GDMT) for heart failure (HF) with reduced ejection fraction (HFrEF; EF<40%) is not contraindicated, but adherence to guidelines is limited. The present study investigated the implementation of GDMT in HFrEF across different age strata in a large nationwide cohort. In HFrEF, gaps persist in the use of medications and devices. In disagreement with current recommendations, older patients remain undertreated. Improving strategies and a more individualized approach for implementing GDMT in HFrEF are required, particularly in older patients.
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