THE ROLE OF QUADRUPLE THERAPY IN PATIENTS WITH ISCHEMIC CARDIOMYOPATHY UNSUITABLE FOR REVASCULARIZATION: A CLINICAL CASE REPORT

Abstract

Coronary artery disease (CAD) is one of the most prevalent cardiovascular disorders and remains the leading cause of disability and mortality worldwide. In developed countries, CAD is the major cause of heart failure, accounting for nearly 60% of chronic heart failure cases. This clinical case demonstrates the management of a patient with ischemic cardiomyopathy and severe heart failure following myocardial infarction. The treatment of patients with ischemic cardiomyopathy and the selection of optimal quadruple therapy remain a major clinical challenge for cardiologists. Considering the increasing number of patients with ischemic cardiomyopathy who are not candidates for coronary revascularization, this clinical case is of particular importance. Quadruple therapy (ACE inhibitors/ARBs/ARNI, beta-blockers, mineralocorticoid receptor antagonists, and SGLT2 inhibitors) represents the cornerstone of treatment in patients with ischemic cardiomyopathy who are not suitable for revascularization. This therapeutic strategy improves quality of life, enhances prognosis, prolongs survival, and reduces hospitalization and mortality associated with heart failure. Keywords: ischemic cardiomyopathy, quadruple therapy, revascularization, heart failure.