Heart failure & cardiomyopathies
Safety, Tolerability and Efficacy of Up-Titration of Guideline-Directed Medical Therapies for Acute Heart Failure in Elderly Patients: A Sub-Analysis of the STRONG-HF Randomized Clinical Trial
Authors' conclusion
High-intensity care after AHF was safe and resulted in a significant reduction of all-cause death or HF readmission at 180 days across the study age spectrum. Older patients have smaller benefits in terms of quality of life.
Study context
- Population
- Patients hospitalised for acute HF not treated with optimal guideline-directed medical therapy (GDMT); older (>65 years) vs younger493 older (>65 years)
- Comparison
- High-intensity care vs usual care, by age
- Primary endpoint
- Death or HF readmission
- Follow-up
- 180 days
Methodological detailssubgroup analysis by age
- Subgroup analysis by age
Primary result
As reported in the abstract
Effect of HIC on death or HF readmission, by age
HIC vs Usual careAdjusted hazard ratio (95% CI)
Younger patients
0.51(0.32–0.82)
Older patients
0.73(0.46–1.15)
Younger patients, excluding COVID-19 deaths
0.51(0.32–0.82)
Older patients, excluding COVID-19 deaths
0.63(0.32–1.02)
Further findings
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| Death or HF readmission, oldervs younger patients · 180 days | 1.02 (0.73–1.43) | P = 0.89 | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Adjusted-mean difference (95% CI) | |
|---|---|---|
| Quality of life (EQ-VAS), by age · day 90HICvs Usual careYounger patients | 5.51 (3.20–7.82) | |
| Quality of life (EQ-VAS), by age · day 90HICvs Usual careOlder patients | 1.77 (−0.75 to 4.29) | |
| −50510Difference (linear scale) |
- Quality of life (EQ-VAS), by age: interaction p = 0.032
GDMT doses, older vs younger
- Older patients received slightly lower GDMT to day 21, but same doses at day 90 and 180
Original publication
Safety, Tolerability and Efficacy of Up-Titration of Guideline-Directed Medical Therapies for Acute Heart Failure in Elderly Patients: A Sub-Analysis of the STRONG-HF Randomized Clinical Trial. Eur J Heart Fail. Published 7 June 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →