Heart failure & cardiomyopathiesSecondary analysis
Differential Rates of Guideline-Directed Medical Therapy Modification in C-MIC and Control Patients: Results from the C-MIC II Trial
- Secondary analysis of the C-MIC II trial
Authors' conclusion
Medication intensity decreased in C-MIC-treated patients but increased in controls, driven primarily by escalation of diuretics, likely reflecting worsening HF. Consistent improvements in LVEF, 6MWD and KCCQ-OSS across SGLT2i subgroups suggest that the observed benefits are independent of background pharmacologic intensification.
Study context
- Population
- Ambulatory patients with chronic non-ischemic HFrEF receiving guideline-directed medical therapy (GDMT)
- Participants
- 65 patients
- Comparison
- C-MIC therapy vs control
- Primary endpoint
- Change in GDMT and diuretic intensity
- Follow-up
- 6 months
Primary result
As reported in the abstract
| Group | GDMT intensity Δ | Diuretic intensity Δ |
|---|---|---|
| control | +0.36 | +0.12 |
| C-MIC device | −0.16 | −0.10 |
Further findings
GDMT adjustments
- GDMT adjustments — Patients with GDMT adjustments
- 25 (39%)
- GDMT adjustments: p= 0.390
Left ventricular ejection fraction (LVEF), by baseline SGLT2i use (subgroup)
- SGLT2i
- +6% [95% CI 3-9; p<0.001]
- without SGLT2i
- +4% [95% CI 2-7; p=0.003]
Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OSS), by baseline SGLT2i use (subgroup)
- SGLT2i
- +42 points [95% CI 26-58; p<0.001]
- without SGLT2i
- +40 [95% CI 28-51; p<0.001]
6MWD, by baseline SGLT2i use (subgroup)
- SGLT2i
- +150 meters [95% CI 88-212; p<0.001]
- without SGLT2i
- +141 meters (95% CI 63-219; p<0.001]
Original publication
Differential Rates of Guideline-Directed Medical Therapy Modification in C-MIC and Control Patients: Results from the C-MIC II Trial. ESC Heart Fail. Published 18 August 2026. doi:10.1093/eschf/xvag220
Summarised from the published abstract; every number is checked against it