Heart failure & cardiomyopathies
Design, Rationale, and Methods of the INITIATE-HFrEF Trial: ARNI and SGLT2 Inhibitors Sequencing in Heart Failure with Reduced Ejection Fraction (HFrEF)
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF)patients randomized
- Participants
- 62 patients
- Planned comparison
- Simultaneous vs sequential initiation of angiotensin receptor-neprilysin inhibitors (ARNi) and SGLT2i in HFrEF
- Simultaneousn = 29
- Sequentialn = 33
- Primary endpoint
- composite of:
- Hypotension
- Hyperkalemia
- Hypokalemia
- Estimated glomerular filtration rate drop ≥50% from baseline
- Emergency visit for HF
- HF hospitalization
- Cardiovascular death
- Follow-up
- ≈24 weeks
No results yet. This paper sets out the design of a trial; its results are to come.
Baseline
Baseline characteristics
- Mean age
- 68.1 ± 10.4 years
- Men
- 65%
- Inpatients
- 48%
- "de novo" HF diagnosis
- 79%
- Prior treatment with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers
- 39%
- Prior beta-blockers
- 61%
- Prior mineralocorticoid receptor antagonists
- 27%
- Mean left ventricular ejection fraction
- 33% ± 9%
- Systolic blood pressure
- 125.3 ± 17.4 mm Hg
- Estimated glomerular filtration rate
- 78.1 ± 23.8 mL/min/1.73 m²
- Serum potassium
- 4.3 ± 0.5 mmol/L
- Baseline characteristics were overall well balanced between groups
First agent in sequential group
- Started on SGLT2i
- 27
- Started on ARNi
- 6
Original publication
Design, Rationale, and Methods of the INITIATE-HFrEF Trial: ARNI and SGLT2 Inhibitors Sequencing in HFrEF. JACC Adv. Published 4 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →