Heart failure & cardiomyopathiesRandomised controlled trial
Burst Steroid Therapy for Acute Heart Failure: The CORTAHF Randomized, Open-Label, Pilot Trial
- Randomised controlled trial
- open-label
- pilot
Authors' conclusion
In this small open-label study of patients with AHF, burst steroid therapy was associated with reduced inflammation as measured by hsCRP levels at day 7 (primary endpoint).
Study context
- Population
- Patients with acute heart failure (HF), NT-proBNP >1500 pg/ml and high-sensitivity C-reactive protein (hsCRP) >20 mg/L
- Participants
- 101 patients
- Comparison
- Burst prednisone vs usual care
- Primary endpoint
- Change in hsCRP
- Follow-up
- Day 7
Primary result
hsCRP (adjusted geometric mean ratio)
Ratio of geometric mean ratios (GMRs)
0.75
95% CI 0.56–1.00
P = 0.0498
By group
Prednisone
0.30
adjusted GMR
Usual care
0.40
adjusted GMR
As reported in the abstract
Secondary outcomes
| Outcome | Prednisone | Usual care | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Worsening HF, HF readmission or death (investigator-reported, unblinded) · 90 days | 10.4% | 30.8% | 0.31 (0.11–0.86) | P = 0.016 | |
| 0.10.31310Hazard ratio (log scale) |
| Outcome | least squares mean difference (points) (95% CI) | P value | |
|---|---|---|---|
| EQ-5D visual analogue scale score (patient-reported, unblinded) · day 7 | 2.57 (0.12–5.01) | P = 0.040 | |
| −50510Difference, points (linear scale) |
Subgroup with centrally-measured interleukin-6 >13 pg/ml (pre-specified)
- All effects statistically significant
Safety
Adverse events
- Adverse events, particularly hyperglycaemia, more frequent with prednisone
- No difference in infection rate
Original publication
Burst Steroid Therapy for Acute Heart Failure: The CORTAHF Randomized, Open-Label, Pilot Trial. Eur J Heart Fail. Published 30 August 2024. doi:10.1002/ejhf.3452
Summarised from the published abstract; every number is checked against it