Heart failure & cardiomyopathiesSecondary analysis
Comprehensive Vasodilatation in Women with Acute Heart Failure: Novel Insights from the GALACTIC Randomized Controlled Trial
- Secondary analysis of the GALACTIC randomised trial
- pre-defined sex-specific analysis
- international
- multicentre
- open-label
- blinded endpoint
Authors' conclusion
Rapid up-titration of RAAS inhibitors was less successfully implemented in women possibly explaining their higher rate of all-cause mortality and rehospitalization for AHF.
Study context
- Population
- Acute HF with increased natriuretic peptides, SBP ≥100 mmHg, planned general-ward treatment288 (37%) women
- Participants
- 781 participants
- Comparison
- Early intensive and sustained vasodilatation vs usual care, by sex
- Primary endpoint
- All-cause mortality or rehospitalization for acute heart failure (AHF)
- Follow-up
- 180 days
Primary result
As reported in the abstract
All-cause mortality or rehospitalisation for AHF, women
- HR adjusted for female sex (treatment strategy by sex)
- 1.62, 95% CI 1.05-2.50; p = 0.03
Further findings
Median
| Outcome | Women | Men |
|---|---|---|
| Discharge % target dose of RAAS inhibitors, intervention arm · median discharge | 50% | 75% |
Discharge % target dose of renin-angiotensin-aldosterone system (RAAS) inhibitors, intervention arm · median discharge
- Rapid RAAS inhibitor up-titration less successful in women vs men (overall and HFrEF)
Original publication
Comprehensive Vasodilatation in Women with Acute Heart Failure: Novel Insights from the GALACTIC Randomized Controlled Trial. Eur J Heart Fail. Published 9 November 2023. doi:10.1002/ejhf.3065
Summarised from the published abstract; every number is checked against it