Heart failure & cardiomyopathies
Comprehensive guideline-directed medical therapy strategies on health status outcomes in patients with heart failure: the LAQUA-HF randomised clinical trial
- multicentre, open-label, randomised, 2×2 factorial design trial
Authors' conclusion
This trial found no evidence of benefit of one treatment over another for health status over 6 months. Given the sample size and predefined power, modest differences between treatments cannot be excluded.
Study context
- Population
- Ambulatory patients with symptomatic heart failure (HF), elevated natriuretic peptide levels and left ventricular ejection fraction (LVEF) <50%, despite conventional therapies (eg, renin-angiotensin-aldosterone system inhibitors and beta-blockers)randomised patients (median age 73 years, median LVEF 36%, 84.0% New York Heart Association class II)
- Participants
- 231 patients
- Comparison
- sacubitril/valsartan vs dapagliflozin, and torsemide vs furosemide
- Primary endpoint
- Change in the Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS)
- Follow-up
- Over 6 months
Primary result
As reported in the abstract
Change in the Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS)
Adjusted mean difference, points (95% CI)P value
sacubitril/valsartan vs dapagliflozinsacubitril/valsartan minus dapagliflozin in the abstract's order; no sign or direction word printed; changes did not differ
2.53(−1.81 to 6.88)
P = 0.25torsemide vs furosemidetorsemide minus furosemide in the abstract's order; no sign or direction word printed; changes did not differ
0.25(−4.10 to 4.59)
P = 0.91Secondary outcomes
| Outcome | win ratio (95% CI) | |
|---|---|---|
| Hierarchical composite outcome (prespecified secondary endpoint) — sacubitril/valsartan vs dapagliflozin · no significant difference | 1.15 (0.71–1.88) | |
| Hierarchical composite outcome (prespecified secondary endpoint) — torsemide vs furosemide · no significant difference | 1.15 (0.70–1.85) | |
| 0.512Win ratio (log scale) |
Original publication
Comprehensive guideline-directed medical therapy strategies on health status outcomes in patients with heart failure: the LAQUA-HF randomised clinical trial. Heart. Published 20 April 2026. doi:10.1136/heartjnl-2025-327642
Summarised from the published abstract; every number is checked against it