Heart failure & cardiomyopathiesSecondary analysis
Long-Term Follow-Up of the TRED-HF Trial: Implications for Therapy in Patients with Dilated Cardiomyopathy and Heart Failure Remission
- Long-term follow-up of the TRED-HF randomised trial
- non-randomised reporting of outcomes
Patients randomised to continue therapy withdrew treatment between 6 and 12 months; restart of therapy recommended post-trial; follow-up until May 2023
Authors' conclusion
The risk of relapse in the 5 years following the TRED-HF trial remained high.
Study context
- Population
- Patients with recovered dilated cardiomyopathy (DCM) after HF therapy withdrawal in TRED-HF
- Participants
- 51 patients
- Primary endpoint
- Relapse: ≥10% reduction in LVEF to <50%, doubling of NT-proBNP to >400 ng/L, or clinical features of HF
Primary result
As reported in the abstract
Relapsed from enrolment to last follow-up (median 6 years, IQR 6-7)
33 of 51 patients (65%)
5-year relapse rate from enrolment
61% (95% CI 45-73)
5-year relapse rate from end of trial
39% (95% CI 19-54)
Further findings
| Outcome | mean difference (CI) | P value | |
|---|---|---|---|
| Mean intensity of therapy, after trial vs enrolment | −6 (−8 to −4) | P < 0.001 | |
| −10−505Difference (linear scale) |
Relapse risk with corrected atrial fibrillation
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Corrected atrial fibrillation | 0.33 (0.12–0.96) | P = 0.042 | |
| 0.10.31310Hazard ratio (log scale) |
Relapse from end of trial · 5 years
- 5-year relapse rate from end of trial
- 39% (95% CI 19-54)
- non-randomised
Recurrent relapse during follow-up among patients who relapsed during the trial
- Recurrent relapse during follow-up
- 9 of 20
Identifiable triggers of relapse during follow-up
- Relapses with identifiable triggers
- One third
- Arrhythmia
- 4
- Pregnancy
- 1
- Hypertension
- 1
- Infection
- 1
Original publication
Summarised from the published abstract; every number is checked against it