Heart failure & cardiomyopathies
Comparative analysis of randomized versus real-world populations in heart failure: DIAMOND trial vs CARE-HK registry
- Comparative analysis of randomized versus real-world populations
Authors' conclusion
This study underscores the value of real-world evidence in complementing RCTs by offering insights into population diversity, comorbidity burden, and prescription behaviours, and highlights the need for more pragmatic and inclusive trials in HF.
Study context
- Population
- Patients with chronic heart failure (HF) and either active hyperkalaemia or high risk for hyperkalaemia
- Comparison
- compare eligibility, clinical profile, and treatment patterns between patients enrolled in the CARE-HK registry and the DIAMOND trial
Primary result
As reported in the abstract
CARE-HK participants meeting DIAMOND's eligibility criteria
CARE-HK participants who met DIAMOND's eligibility criteria
17.2%
when excluding patients with missing data
3.4%
Further findings
Age
Women
Treatment use in the HFrEF subgroup
angiotensin receptor-neprilysin inhibitors
sodium-glucose transport protein 2 inhibitors
quadruple therapy
Women
- CARE-HK enrolled an older (71.8 vs 67.2 years), more diverse population with more women (31.5% vs 27.6%) and greater burden of comorbidities than DIAMOND
Renal dysfunction
- Patients exhibited more advanced renal dysfunction, especially in the HF with reduced ejection fraction (HFrEF) population
Guideline-directed medical therapy uptake
- uptake in guideline-directed medical therapy remained incomplete, especially within HFrEF, and renin-angiotensin-aldosterone system inhibitor dosing was often suboptimal
Original publication
Comparative analysis of randomized versus real-world populations in heart failure: DIAMOND trial vs CARE-HK registry. ESC Heart Fail. Published 29 May 2026. doi:10.1093/eschf/xvag155
Summarised from the published abstract; every number is checked against it