Sex-Specific Analysis of Rapid Up-Titration of GDMT After Hospitalisation for Acute Heart Failure
abstract
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Access this abstract nowAIMS
The aim of this study was to evaluate efficacy and safety of rapid up-titration of guideline directed medical therapies in men and women hospitalized for acute heart failure (AHF).
METHODS AND RESULTS
In STRONG-HF AHF patients were randomised just prior to discharge to either usual care (UC) or a high-intensity care (HIC) strategy of guideline-directed medical therapies (GDMT) up-titration. In these analyses, we compare the implementation, efficacy, and safety of the HIC strategy between men and women. In the randomised 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 HF readmission or death, occurred in 15.8% HIC women vs 23.5% women in the UC group (adjusted HR 0.67 [95% CI 0.40-1.13]) and in 14.9% HIC men vs 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 hospitalisation can and should be implemented similarly in men and women, as it results in reduction of 180-day all-cause death or HF readmission, quality-of-life improvement in both men and women with a similar safety profile.
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Additional Info
Sex-specific analysis of the rapid up-titration of guideline-directed medical therapies after a hospitalisation for acute heart failure: insights from the STRONG-HF trial
Eur. J. Heart Fail 2023 May 16;[EPub Ahead of Print], K Čerlinskaitė-Bajorė, CSP Lam, K Sliwa, M Adamo, JM Ter Maaten, V Léopold, A Mebazaa, B Davison, C Edwards, M Arrigo, M Barros, J Biegus, O Chioncel, A Cohen-Solal, A Damasceno, R Diaz, G Filippatos, E Gayat, A Kimmoun, M Metra, M Novosadova, M Pagnesi, PS Pang, P Ponikowski, H Saidu, K Takagi, D Tomasoni, AA Voors, G Cotter, J ČelutkienėFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.