Heart failure & cardiomyopathies
Characteristics, treatment, and outcomes of early vs. late enrollees of the STRONG-HF trial
Primary result · All-cause death or HF readmissionResult — go to the resultAdjusted hazard ratio 0.65 95% CI 0.42–0.99Authors' conclusion
Late enrollees have different clinical characteristics and higher event rates compared to early enrollees. GDMT implementation in the HIC arm robustly achieved similar doses with consistent efficacy in early and late enrollees, mitigating the higher risk of adverse outcome in late enrollees.
Study context
- Population
- Patients enrolled in STRONG-HF (high-intensity care (HIC) vs usual care (UC) after heart failure (HF) hospitalisation)
- Participants
- 1,078 patients
- Comparison
- Early vs late enrollees
- Earlyn = 342
- Laten = 736reference
- Primary endpoint
- Primary outcome
Primary result
All-cause death or HF readmission · 180 days
Adjusted hazard ratio
0.65
95% CI 0.42–0.99
P = 0.044
By group
As reported in the abstract
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| Efficacy of HIC vs UC by enrolment group (primary outcome)HICvs UCEarly enrollees | 0.77 (0.35–1.67) | |
| Efficacy of HIC vs UC by enrolment group (primary outcome)HICvs UCLate enrollees | 0.58 (0.40–0.83) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Primary outcome in UC, late vs early · UC arm; trend
P = 0.10
Primary outcome in HIC, late vs early · HIC arm
P = 0.73
- Efficacy of HIC vs UC by enrolment group (primary outcome): adjusted interaction-P = .51
Average % of optimal guideline-directed medical therapy (GDMT) dose after randomisation
- No treatment-by-enrolment interaction; consistently higher with HIC vs UC in early and late
Renin-angiotensin-inhibitor use, HIC vs UC by enrolment
- Higher use with HIC more pronounced in late enrollees after randomisation
- interaction-P = .013
- Higher use with HIC more pronounced in late enrollees at 90 days
- interaction-P < .001
Safety
- No interaction observed for safety events
Original publication
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