Heart failure & cardiomyopathiesSecondary analysis
NT-proBNP and high intensity care for acute heart failure: the STRONG-HF trial
- Secondary analysis of the STRONG-HF randomised trial
Authors' conclusion
Among patients with acute HF enrolled in STRONG-HF, HIC reduced 180-day HF readmission or death regardless of baseline NT-proBNP. GRMT up-titration early post-discharge, utilizing increased NT-proBNP as guidance to increase diuretic therapy and reduce the GRMT up-titration rate, resulted in the same 180-day outcomes regardless of early post-discharge NT-proBNP change.
Study context
- Population
- Patients hospitalized for acute heart failure (HF) with >10% NT-proBNP decrease from screening (admission) to randomization (pre-discharge)
- Participants
- 1,077 patients
- Comparison
- Decreased NT-proBNP vs Stable NT-proBNP vs Increased NT-proBNP
- Primary endpoint
- HF readmission or death
- Follow-up
- 180 days
Primary result
As reported in the abstract
High intensity care (HIC), increased vs decreased NT-proBNP (randomization to 1 week): no difference in outcome at 180 days, 13.5% vs. 13.2%
P = 0.93
Further findings
| Outcome | Decreased NT-proBNP | Stable NT-proBNP | Increased NT-proBNP | P value |
|---|---|---|---|---|
| 180-day HF readmission or death at 60 days, HIC by NT-proBNP change | 2.2% | Not reported in the abstract | 8.3% | P = 0.039 |
| 180-day HF readmission or death at 90 days, HIC by NT-proBNP change | 4.0% | Not reported in the abstract | 11.1% | P = 0.045 |
Optimal guideline-recommended medical therapy (GRMT) doses reached, HIC by NT-proBNP change · 6 months
- Increased NT-proBNP reached 70.4% optimal GRMT doses, compared with 80.3% for those with NT-proBNP decrease
- Increased NT-proBNP: more diuretics and slower up-titration in the first weeks after discharge (per protocol)
Original publication
Summarised from the published abstract; every number is checked against it