6/29/23, 11:57 PM STRONG-HF Pathway Feedback Search Clinical Topics Home Studies STRONG HF STRONG HF Disease Heart failure Trial question What is the role of up-titration of guideline-directed medical therapies in patients with acute HF? Study design Multi-center Open label RCT Population Characteristics of study participants 39.0% female N = 1078 61.0% male 1078 patients (416 female, 662 male) Inclusion criteria: patients aged 18-85 years admitted to hospital with acute HF, not treated with full doses of guideline-directed drug treatment Key exclusion criteria: age < 18 or > 85 years; intolerance to high doses of -blockers and renin- angiotensin system blockers; mechanical ventilation in the 24 hours prior to screening Interventions N=542 high-intensity care (rapid up-titration of guideline-directed drug treatments to 100% of recommended doses and close follow-up) N=536 usual care (usual local practice) Primary outcome https://web.pathway.md/studies/rectdFfuNTIdLCaLD 1/2 6/29/23, 11:57 PM STRONG-HF Pathway Readmission to hospital due to heart failure or death at day 180 23.3 % 23.3 17.5 % 15.2 11.7 % Significant decrease 5.8 % NNT = 12 0.0 % High-intensity care Usual care Significant decrease in readmission to hospital due to HF or death at day 180 (15.2% vs. 23.3%; RR 0.66, 95% CI 0.5 to 0.86) Secondary outcomes Significant increase in elevation in the EuroQol VAS at 12 months (10.72 vs. 7.22; AD 3.49, 95% CI 1.74 to 5.24) Significant increase in death from all causes at day 180 (8.5% vs. 10%; AD 1.6%, 95% CI 0.56 to 1.26) Safety outcomes No significant difference in serious adverse events and fatal adverse events. Significant difference in adverse events by day 90 (41% vs. 29%). Conclusion In patients aged 18-85 years admitted to hospital with acute HF, not treated with full doses of guideline-directed drug treatment, high-intensity care was superior to usual care with respect to readmission to hospital due to HF or death at day 180. Reference Alexandre Mebazaa, Beth Davison, Ovidiu Chioncel et al. Safety, tolerability and efficacy of up- titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial. Lancet. 2022 Dec 3;400(10367):1938-1952. Open reference URL https://web.pathway.md/studies/rectdFfuNTIdLCaLD 2/2