| Authors |
Čerlinskaitė-Bajorė, Kamilė ; Lam, Carolyn S.P ; Sliwa, Karen ; Adamo, Marianna ; Ter Maaten, Jozine M ; Léopold, Valentine ; Mebazaa, Alexandre ; Davison, Beth ; Edwards, Christopher ; Arrigo, Mattia ; Barros, Marianela ; Biegus, Jan ; Chioncel, Ovidiu ; Cohen-Solal, Alain ; Damasceno, Albertino ; Diaz, Rafael ; Filippatos, Gerasimos ; Gayat, Etienne ; Kimmoun, Antoine ; Metra, Marco ; Novosadova, Maria ; Pagnesi, Matteo ; Pang, Peter S ; Ponikowski, Piotr ; Saidu, Hadiza ; Takagi, Koji ; Tomasoni, Daniela ; Voors, Adriaan A ; Cotter, Gad ; Čelutkienė, Jelena |
| Abstract [eng] |
Aims: The aim of this study was to evaluate efficacy and safety of rapid up-titration of guideline-directed medical therapies (GDMT) in men and women hospitalized for acute heart failure (AHF). Methods and results: In STRONG-HF, AHF patients were randomized just prior to discharge to either usual care (UC) or a high-intensity care (HIC) strategy of GDMT up-titration. In these analyses, we compared the implementation, efficacy, and safety of the HIC strategy between men and women. In the randomized AHF population, 416/1078 (39%) were women. By day 90, a higher proportion of both sexes in the HIC group had been up-titrated to full doses of GDMT compared to UC. Overall, there were no differences in the primary endpoint between the sexes. The primary endpoint, 180-day heart failure readmission or death, occurred in 15.8% HIC women versus 23.5% women in the UC group (adjusted hazard ratio [HR] 0.67, 95% confidence interval [CI] 0.40–1.13) and in 14.9% HIC men versus 23.5% UC men (adjusted HR 0.57, 95% CI 0.38–0.88) (adjusted interaction p = 0.65). There was no significant treatment-by-sex interaction in quality-of-life improvement or in adverse events, including serious or fatal adverse events. Conclusion: The results of the current analyses suggest that a rapid up-titration of GDMT immediately after an AHF hospitalization can and should be implemented similarly in men and women, as it results in reduction of 180-day all-cause death or heart failure readmission, quality-of-life improvement in both men and women with a similar safety profile. |
