Heart failure & cardiomyopathies
Impact of Rapid Up-Titration of Guideline-Directed Medical Therapies on Quality of Life: Insights From the STRONG-HF Trial
Primary result · Improvement in EQ-VAS (QoL)Result — go to the resultMean difference 4.2 95% CI 2.5–5.8Authors' conclusion
Early up-titration of guideline-directed medical therapy significantly improves all dimensions of QoL in patients with HF and improves prognosis regardless of baseline self-assessed health status. The likelihood of achieving optimal doses of HF medications does not depend on baseline QoL.
Study context
- Population
- Patients with acute heart failure (HF) randomised just before discharge, with available quality of life (QoL) assessmentwith available QoL assessment
- Participants
- 1,072 patients
- Comparison
- High-intensity care vs usual care
- High-intensity caren = 539
- Usual caren = 533reference
Primary result
Improvement in EQ-VAS (QoL) · 90 days
Mean difference
4.2
95% CI 2.5–5.8
P < 0.001
As reported in the abstract
Further findings
Baseline EQ-VAS score · mean baseline
- Mean baseline EQ-VAS, no difference between treatment groups
- 59.2 (SD, 15.1)
Characteristics of lower baseline EQ-VAS (worse QoL) · mean baseline
- More likely women, self-reported Black and non-European
- P < 0.001
Independent predictors of greater QoL improvement
- Younger age
- P < 0.001
- No HF hospitalisation in previous year
- P < 0.001
- Lower NYHA class before admission
- P < 0.001
QoL benefit by subgroup (age, LVEF above/below 40%, NT-proBNP and SBP above/below median)
- No statistically significant heterogeneity in benefit of high-intensity care across subgroups
Treatment effect on trial primary end point by baseline EQ-VAS
- Did not vary significantly across baseline EQ-VAS
- P for interaction = 0.87
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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