Heart failure & cardiomyopathies
Effects of Rapid Uptitration of Neurohormonal Blockade on Effective, Sustainable Decongestion and Outcomes in STRONG-HF
Authors' conclusion
In STRONG-HF, intensive uptitration of neurohormonal blockade was associated with more efficient and sustained decongestion at day 90 and a lower risk of the primary endpoint.
Study context
- Population
- Patients with acute HF
- Comparison
- High-intensity care with fast uptitration of neurohormonal blockade vs usual care
Primary result
As reported in the abstract
Successful decongestion · day 90
P = 0.0001
Further findings
Successful decongestion at baseline
P = 0.52
| Outcome | Adjusted mean difference (kg) (95% CI) | P value | |
|---|---|---|---|
| Weight reductionFavoured HIC | −1.36 (−1.92 to −0.79) | P < 0.001 | |
| −2−101Difference, kg (linear scale) |
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Risk of 180-day HF readmission or all-cause death, by decongestion status (all subjects) · 180 daysSuccessful decongestionvs No successful decongestion | 0.40 (0.27–0.59) | P < 0.0001 | |
| 0.20.5125Hazard ratio (log scale) |
- Risk of 180-day HF readmission or all-cause death, by decongestion status (all subjects): HR of 180-day HF readmission or all-cause death (lower risk with successful decongestion)
Each component of congestion score · day 90
- Each component significantly better with high-intensity care (HIC)
- all, P < 0.05
NT-proBNP level and orthopnea severity
- NT-proBNP and lower orthopnea severity favoured HIC
- all, P < 0.001
Mean daily loop diuretic dose · day 90
- Lower mean daily loop diuretic dose with HIC
Sustained decongestion (patients decongested at baseline) · day 90
- Significantly better chance of sustaining decongestion with HIC
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Effects of Rapid Uptitration of Neurohormonal Blockade on Effective, Sustainable Decongestion and Outcomes in STRONG-HF. J Am Coll Cardiol. Published 23 July 2024. doi:10.
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