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Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial
Open accessAbstract
Background There is a paucity of evidence for dose and pace of up-titration of guideline-directed medical therapies after admission to hospital for acute heart failure.Methods In this multinational, open-label, randomised, parallel-group trial (STRONG-HF), patients aged 18-85 years admitted to hospital with acute heart failure, not treated with full doses of guideline-directed drug treatment, were recruited from 87 hospitals in 14 countries. Before discharge, eligible patients were randomly assigned (1:1), stratified by left ventricular ejection fraction (≤40% vs >40%) and country, with blocks of size 30 within strata and randomly ordered sub-blocks of 2, 4, and 6, to either usual care or high-intensity care. Usual care followed usual local practice, and high-intensity care involved the up-titration of treatments to 100% of recommended doses within 2 weeks of discharge and four scheduled outpatient visits over the 2 months after discharge that closely monitored clinical status, laboratory values, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations. The primary endpoint was 180-day readmission to hospital due to heart failure or all-cause death. Efficacy and safety were assessed in the intention-to-treat (ITT) population (ie, all patients validly randomly assigned to treatment). The primary endpoint was assessed in all patients enrolled at hospitals that followed up patients to day 180. Because of a protocol amendment to the primary endpoint, the results of patients enrolled on or before this amendment were down-weighted. This study is registered with ClinicalTrials.gov, NCT03412201, and is now complete.Findings Between May 10, 2018, and Sept 23, 2022, 1641 patients were screened and 1078 were successfully randomly assigned to high-intensity care (n=542) or usual care (n=536; ITT population). Mean age was 63·0 years (SD 13·6), 416 (39%) of 1078 patients were female, 662 (61%) were male, 832 (77%) were White or Caucasian, 230 (21%) were Black, 12 (1%) were other races, one (<1%) was Native American, and one (<1%) was Pacific Islander (two [<1%] had missing data on race). The study was stopped early per the data and safety monitoring board's recommendation because of greater than expected between-group differences. As of data cutoff (Oct 13, 2022), by day 90, a higher proportion of patients in the high-intensity care group had been up-titrated to full doses of prescribed drugs (renin-angiotensin blockers 278 [55%] of 505 vs 11 [2%] of 497; β blockers 249 [49%] vs 20 [4%]; and mineralocorticoid receptor antagonists 423 [84%] vs 231 [46%]). By day 90, blood pressure, pulse, New York Heart Association class, bodyweight, and NT-proBNP concentration had decreased more in the high-intensity care group than in the usual care group. Heart failure readmission or all-cause death up to day 180 occurred in 74 (15·2% down-weighted adjusted Kaplan-Meier estimate) of 506 patients in the high-intensity care group and 109 (23·3%) of 502 patients in the usual care group (adjusted risk difference 8·1% [95% CI 2·9-13·2]; p=0·0021; risk ratio 0·66 [95% CI 0·50-0·86]). More adverse events by 90 days occurred in the high-intensity care group (223 [41%] of 542) than in the usual care group (158 [29%] of 536) but similar incidences of serious adverse events (88 [16%] vs 92 [17%]) and fatal adverse events (25 [5%] vs 32 [6%]) were reported in each group.Interpretation An intensive treatment strategy of rapid up-titration of guideline-directed medication and close follow-up after an acute heart failure admission was readily accepted by patients because it reduced symptoms, improved quality of life, and reduced the risk of 180-day all-cause death or heart failure readmission compared with usual care.Funding Roche Diagnostics.
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“Therapy with dapagliflozin 10 mg o.d. vs. placebo reduced the risk of the primary outcome, a composite of worsening HF (hospitalization or an urgent visit resulting in i.v.therapy for HF) or CV death, by 26% (HR 0.74; 95% CI, 0.65-0.85).”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [492]
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“In addition, dapagliflozin reduced all-cause mortality (HR 0.83; 95% CI, 0.71-0.97)and improved symptoms, physical function, and quality of life in patients with HFrEF.491,492”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [492]
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“8 The aim of the present study was to examine and compare the responses to a fluid and sodium challenge followed by intravenous (IV) loop diuretic administration in patients with stable HF before and after the initiation of sacubitril/ valsartan.”
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Telephone-Based Guideline-Directed Medical Therapy Optimization in Navajo Nation
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“6,29–3 1”
Self-citationA Generalizable Approach to Quantifying Guideline-Directed Medical Therapy
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Self-citationTreatment Strategies of Improving Quality of Care in Patients With Heart Failure
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“Since the guidelines were published, results from the STRONG-HF trial demonstrated that an intensive strategy of rapid up-titration and close follow-up reduced symptoms, improved quality of life (QoL), and reduced 180 day death or HF readmission compared with usual care in patients with acute HF. 14 The role of qualit…”
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“Recently, more timely and aggressive interventions to initiate and titrate RAASi demonstrated improved hospitalization and mortality outcomes among hospitalized heart failure patients [30].”
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“6 Moreover, cost estimates of routine care, drug cost, and personnel cost were based on US estimates and may differ in other countries along with the cost-effectiveness threshold.”
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“62 However, the cost of HF treatment is tremendous for the average of patients living in SSA.”
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“23–25 It is essential for clinicians to acknowledge that a significant proportion of patients hospitalized for HF have a high risk of either death or re-hospitalization within 30 days postdischarge.”
Diabetic cardiomyopathy: insights into pathophysiology, diagnosis and clinical management
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Heart Failure Nurses within the Primary Care Setting
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“39 This multinational randomised trial included 1,078 patients due to be discharged following an episode of decompensation.”
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“This strategy has been tested in the intensive treatment strategy of the rapid up-titration of guideline-directed medication (at least two neurohor-monal blockers) in stable hospitalized patients can overcome residual decongestion and improve outcomes [116].”
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“Natriuretic peptides should be interpreted as continuous known as the intermediate or grey zone , typically have better diagnostic outcomes than those with values above the diagnostic cut offs for heart failure 32,33 .”
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“39 Namely, the initial step would be to make sure that all physicians that have to manage patients with ADHF are aware of the current HF guidelines.”
BackgroundSelf-citationHerzinsuffizienz: Leitlinien-Update der ESC 2023
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Self-citationHeart failure management with β-blockers: can we do better?
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“…HFrEF was studied prospectively in the STRONG-HF study, in which 1,078 patients discharged from hospital following admission for acute HF were randomised to either guideline-driven up-titration of medical therapies to their maximal tolerated doses, or to usual care from their local physician 86 .”
MethodBiegus, J., Cotter, G., Davison, B. A., Freund, Y., Voors, A. A., Edwards, C., Novosadova, M., Takagi, K., Hayrapetyan, H. G., Mshetsyan, A., et al. (2024) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2024.09.002 · Cited by 19
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“3,21 Our fi ndings show improved performance in HF drug prescription compared with a previous analysis of the Italian HF population reported in the phase 1 of the BLITZ-HF study 6 that re fl ected the 2016 European HF guidelines, where, at variance with the current guidelines, a stepwise approach to…”
Self-citationWorsening heart failure: progress, pitfalls, and perspectives
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“…and subsequent titration of GDMT during frequent post-discharge follow-up with monitoring of clinical status and laboratory values with serial measurements of NT-proBNP, as it reduced symptoms, improved QoL, and reduced the risk of all-cause death or HF readmission compared with usual care [121].”
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“60,64 Even though the STRONG-HF strategy was proved in patients with acute decompensated HF, the strategy could easily be used in outpatients with HF, provided there is adequate follow-up with clinical and biochemical assessment.”
BackgroundMethodInfluentialWearable technologies to predict and prevent and heart failure hospitalizations: a systematic review
Noci, F., Capodici, A., Nuti, S., Passino, C., Emdin, M., & Giannoni, A. (2025) · European Heart Journal - Digital Health · doi:10.1093/ehjdh/ztaf079 · Cited by 20
“38 Concurrently, wearable-guided monitoring enabled more aggressive uptitration of disease-modifying therapies, in line with the evidences provided by the STRONG-HF 39 and PIONEER-HF 40 trials.”
Beldhuis, I. E., Damman, K., Pang, P. S., Greenberg, B., Davison, B. A., Cotter, G., Gimpelewicz, C. R., Felker, G. M., Filippatos, G. S., Teerlink, J. R., et al. (2023) · European Journal of Heart Failure · doi:10.1002/ejhf.2975 · Cited by 17
“The four categories consisted of (1) patients who were not on MRA therapy during admission, (2) patients in which MRA therapy was discontinued during admission, (3) patients where MRA therapy was initiated during admission, and (4) patients in which MRA therapy was continued during hospital admission.”
BackgroundSelf-citationHarrington, J., Rao, V. N., Leyva, M., Oakes, M., Mentz, R. J., Bosworth, H. B., & Pagidipati, N. J. (2023) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2023.12.004 · Cited by 19
Guidelines for treating heart failure
Kittleson, M. M. (2024) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2024.10.002 · Cited by 18
A Randomized Controlled Trial of Thoracentesis in Acute Heart Failure
Glargaard, S., Thomsen, J. H., Tuxen, C., Lindholm, M. G., Bang, C. A., Schou, M., Iversen, K. K., Rasmussen, R. V., Løgstrup, B. B., Vraa, S., et al. (2025) · Circulation · doi:10.1161/circulationaha.124.073521 · Cited by 16
“36,37”
Sliwa, K. S., Stewart, S., Viljoen, C. A., Allie, S., Hähnle, J., Damasceno, A. A. M., Jessen, N., Sani, M. U., Nel, G., Smith, D., et al. (2025) · Global Heart · doi:10.5334/gh.1449 · Cited by 17
“From our recent publication of the STRONG-HF study (37), we have learned that rapid up-titration of heart failure therapies under close follow-up (including clinical examination and NT-proBNP monitoring) is safe, reduces heart failure readmissions and all-cause mortality, and improves patients’…”
Self-citationVaduganathan, M., Claggett, B. L., Chatur, S., Desai, A. S., Jhund, P. S., Vardeny, O., Merkely, B. P., Martínez, F. A., Colet, J. C., Saraiva, J. F. K., et al. (2025) · Nature Medicine · doi:10.1038/s41591-025-04037-3 · Cited by 18
“Although initial data from implementation trials 24 suggest that the rapid, sequential initiation of multidrug regimens is generally safe, a more gradual, stepwise approach may be necessary for patients predicted to have poorer tolerability (such as those who are frail or clinically unstable).”
Ferreira, J. P., Blatchford, J., Teerlink, J. R., Kosiborod, M., Angermann, C. E., Biegus, J., Collins, S. P., Tromp, J., Nassif, M. E., Psotka, M. A., et al. (2023) · European Journal of Heart Failure · doi:10.1002/ejhf.2982 · Cited by 16
Self-citationMartens, P., Burkhoff, D., Cowger, J. A., Jorde, U. P., Kapur, N. K., & Tang, W. H. W. (2023) · JACC Heart Failure · doi:10.1016/j.jchf.2023.06.021 · Cited by 16
Shakoor, A., Kamar, S. A., Malgie, J., Kardys, I., Schaap, J., de Boer, R. A., Mieghem, N. M. V., van der Boon, R. M. A., & Brugts, J. J. (2023) · European Journal of Heart Failure · doi:10.1002/ejhf.3048 · Cited by 17
“90 The exact duration of the vulnerable phase remains unclear, but early data suggest an approximate duration of 3–6months.”
BackgroundOriecuia, C., Tomasoni, D., Sala, I., Bonfioli, G. B., Adamo, M., Gussago, C., Lombardi, C., Pagnesi, M., Savarese, G., Metra, M., et al. (2023) · European Heart Journal - Cardiovascular Pharmacotherapy · doi:10.1093/ehjcvp/pvad088 · Cited by 17
Self-citationDecongestion in Acute Heart Failure—Time to Rethink and Standardize Current Clinical Practice?
Bilgeri, V., Spitaler, P., Puelacher, C., Messner, M., Adukauskaitė, A., Barbieri, F., Bauer, A., Senoner, T., & Dichtl, W. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13020311 · Cited by 16
“The recently published STRONG-HF trial [27] randomizing 1078 patients clearly proved the benefit of intensive post-discharge management aiming to reach an up-titration of neurohumoral medication to 100% of recommended doses within 2 weeks.”
Sato, R., Koziolek, M. J., & von Haehling, S. (2024) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2024.10.024 · Cited by 16
Chinese Guidelines for the Diagnosis and Treatment of Heart Failure 2024
Chinese Society of Cardiology, C. M. A., Chinese College of Cardiovascular Physician, Chinese Heart Failure Association of Chinese Medical Doctor Association, & Editorial Board of Chinese Journal of Cardiology (2025) · Cardiology Discovery · doi:10.1097/cd9.0000000000000146 · Cited by 17
Rapid and Intensive Guideline-Directed Medical Therapy for Heart Failure: 5 Core Principles
Greene, S. J., Butler, J., & Fonarow, G. C. (2024) · Circulation · doi:10.1161/circulationaha.124.070228 · Cited by 16
Addressing ‘Residual Congestion’ to Improve Prognosis After Acute Heart Failure Decompensation
Gąsecka, A., & Siniarski, A. (2025) · Cardiac failure review · doi:10.15420/cfr.2024.24 · Cited by 15
“50 Consequently, the current 2023 ESC guidelines for managing chronic and acute HF advocate for an intensive approach to initiate and promptly uptitrate evidence-based medications before discharge and during frequent follow-up.”
Multi-level implementation strategies to improve uptake of evidence-based therapies in heart failure
Jalloh, M. B., Granger, C. B., Fonarow, G. C., & Spall, H. G. C. V. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad150 · Cited by 15
Beles, M., Masuy, I., Verstreken, S., Bartúnek, J., Dierckx, R., Heggermont, W., Oeste, C. L., Boeck, M. D., Fovel, I., Maris, M., et al. (2023) · ESC Heart Failure · doi:10.1002/ehf2.14381 · Cited by 14
“The presence of T2D and CKD negatively impacted all-cause mortality [T2D: hazard ratio (HR) = 1.49, P < 0.01; CKD: HR = 2.05, P < 0.001] and hospital readmission events in all patients with HF. Eligibility for SGLT2is dapagliflozin and empagliflozin was 86.5% (n = 1153) and 97.9% (n = 1305) of the study population, re…”
InfluentialMan, J. P., Klopotowska, J. E., Asselbergs, F. W., Handoko, M. L., Chamuleau, S. A. J., & Schuuring, M. J. (2024) · Current Heart Failure Reports · doi:10.1007/s11897-024-00649-x · Cited by 15
Cannata, A. N., Mizani, M. A., Bromage, D. I., Piper, S. E., Hardman, S. M. C., Sudlow, C. L. M., de Belder, M., Deanfield, J. E., Gardner, R. S., Clark, A. L., et al. (2024) · European Journal of Heart Failure · doi:10.1002/ejhf.3306 · Cited by 15
Heart Failure and All-Cause Hospitalizations in Patients With Heart Failure
Sayed, A. A., ElRefaei, M., Awad, K., Salah, H., Mandrola, J. M., & Foy, A. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.46684 · Cited by 15
Rajzer, P., & Biegus, J. (2025) · Heart Failure Reviews · doi:10.1007/s10741-024-10471-1 · Cited by 20
Cotter, G., Davison, B. A., Solal, A. C., Freund, Y., & Mebazaa, A. (2022) · European Journal of Heart Failure · doi:10.1002/ejhf.2754 · Cited by 14
Self-citationNovel Strategies to Improve Prescription of Guideline-Directed Medical Therapy in Heart Failure
Brooksbank, J. A., Faulkenberg, K. D., Tang, W. H. W., & Martyn, T. (2023) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-023-00979-4 · Cited by 14
Voors, A. A. (2023) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2023.08.017 · Cited by 14
Self-citationBhatt, A. S., Fonarow, G. C., Greene, S. J., Holmes, D. N., Alhanti, B., DeVore, A. D., Butler, J., Heidenreich, P. A., Huang, J., Kittleson, M. M., et al. (2023) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2023.09.005 · Cited by 16
Stolfo, D., Benson, L., Lindberg, F., Dahlström, U., Käck, O., Sinagra, G., Lund, L. H., & Savarese, G. (2024) · European Journal of Heart Failure · doi:10.1002/ejhf.3404 · Cited by 15
Acute Heart Failure and Non-Ischemic Cardiomyopathies: A Comprehensive Review and Critical Appraisal
Manzi, L., Buongiorno, F., Narciso, V., Florimonte, D., Forzano, I., Castiello, D. S., Sperandeo, L., Paolillo, R., Verde, N., Spinelli, A. M., et al. (2025) · Diagnostics · doi:10.3390/diagnostics15050540 · Cited by 18
“…safety, tolerability, and efficacy of rapid optimization, helped by NT-proBNP testing, of heart failure therapies) trial, the percentages of patients with ischemic vs. non-ischemic CMPs were similar (48% and 52%, respectively); however, no data on outcomes according to etiology are available [26].”
Kanai, M., Minamisawa, M., Motoki, H., Seko, Y., Kimura, K., Okano, T., Ueki, Y., Yoshie, K., Kato, T., Saigusa, T., et al. (2023) · Circulation Journal · doi:10.1253/circj.cj-22-0712 · Cited by 14
Changes in Liver Function Tests, Congestion, and Prognosis After Acute Heart Failure
Myhre, P. L., Grupper, A., Mebazaa, A., Davison, B. A., Edwards, C., Takagi, K., Adamo, M., Arrigo, M., Barros, M., Biegus, J., et al. (2025) · JACC Advances · doi:10.1016/j.jacadv.2025.101607 · Cited by 13
Self-citationMoghaddam, N., Lindsay, M. P., Hawkins, N. M., Anderson, K., Ducharme, A., Lee, D. S., McKelvie, R. S., Poon, S., Desmarais, O. H., Desbiens, M., et al. (2023) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2023.06.430 · Cited by 13
Samsky, M. D., Leverty, R., Gray, J. M., Davis, A., Fisher, B., Govil, A., Stanis, T., & DeVore, A. D. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12144676 · Cited by 14
“Recent studies that are similar in design include the “Safety, tolerability, and efficacy of up-titration of guideline-directed medical therapies for acute heart failure” (STRONGHF) [22].”
MethodPagnesi, M., Lombardi, C., Tedino, C., Chiarito, M., Stolfo, D., Baldetti, L., Adamo, M., Calì, F., Inciardi, R. M., Tomasoni, D., et al. (2023) · ESC Heart Failure · doi:10.1002/ehf2.14539 · Cited by 12
“1 However, its role is limited in speci fi c settings such as that of the patients hospitalized for acute HF. 13 – 16 The role of LVEF in patients with signs of advanced HF remains, however, unclear.”
BackgroundInfluentialSelf-citationMultifaceted Strategy Based on Automated Text Messaging After a Recent Heart Failure Admission
Rohde, L. E. P., Rover, M. M., Filho, C. R. H., Rabelo, E. R., Silvestre, O. M., Martins, S. M., Passos, L. C. S., Neto, J. A. D. F., Danzmann, L. C., Silveira, F. S., et al. (2023) · JAMA Cardiology · doi:10.1001/jamacardio.2023.4501 · Cited by 13
Clephas, P. R. D., Malgie, J., Schaap, J., Koudstaal, S., Emans, M. E., Linssen, G. C. M., de Boer, G. A., van Heerebeek, L., Borleffs, C. J. W., Manintveld, O. C., et al. (2023) · ESC Heart Failure · doi:10.1002/ehf2.14604 · Cited by 13
“12 Aside from bene fi ts on the primary clinical outcome, bene fi ts of high-intensity care extended across multiple other endpoint domains.”
BackgroundOptimising Transitional Care Following a Heart Failure Hospitalisation in Australia
Sindone, A. P., Driscoll, A. L., Audehm, R. G., Sverdlov, A. L., McVeigh, J., Chan, W. P. A., Hickey, A., Hopper, I., Chang, T., Maiorana, A., et al. (2024) · Heart Lung and Circulation · doi:10.1016/j.hlc.2023.11.029 · Cited by 16
Use of Sodium–Glucose Cotransporter 2 Inhibitors in Hospitalized Patients
Ünlü, O., Bhatt, A. S., & Blood, A. J. (2024) · JACC Advances · doi:10.1016/j.jacadv.2024.101024 · Cited by 13
Implementation and evaluation of specialist heart failure pharmacist prescribing clinics
Campbell, G., Doherty, C., D’Silva, A., Carr‐White, G., Webb, J., & Ismail, T. F. (2024) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-024-01808-9 · Cited by 17
“The publication of STRONG-HF has demonstrated the safety and efficacy of rapid-optimisation of GDMT post-hospitalisation [25].”
InfluentialConsistency of HFrEF treatment effect in underrepresented groups in randomized clinical trials
Baudry, G., Monzo, L., Petrie, M. C., Girerd, N., Piña, I. L., Mebazaa, A., Butler, J., Abid, L., Zannad, F. M., & Spall, H. G. C. V. (2024) · npj Cardiovascular Health · doi:10.1038/s44325-024-00028-4 · Cited by 13
Self-citationHill, L., Girerd, N., Castiello, T., Jaarsma, T., Metra, M., Rosano, G. M. C., Savage, P., Schuuring, M. J., Simpson, M., Uchmanowicz, I., et al. (2024) · European Journal of Heart Failure · doi:10.1002/ejhf.3519 · Cited by 13
Self-citationHollenberg, S. M. (2025) · Current Cardiology Reports · doi:10.1007/s11886-024-02175-7 · Cited by 13
“…(Safety, Tolerability and Efficacy of Up-Titration of Guideline Directed Medical Therapies for Acute Heart Failure) trial showed that in-hospital initiation and post-discharge up-titration of GDMT with close follow-up can improve clinical outcomes for patients hospitalized for heart failure [ 24 ].”
Baris, R. O., & Tabit, C. E. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14165894 · Cited by 17
“This supports the need to extend HF-DMPs to include treatment titration processes [91].”
Is telemonitoring for heart failure ready after a journey longer than two decades?
Koehler, F., & Hindricks, G. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad395 · Cited by 13
Pena, D.-L., Ilieșiu, A.-M., Aurelian, J., Grigore, M., Hodorogea, A. S., Ciobanu, A., Weiss, E., Bădilă, E., & Balahura, A.-M. (2025) · Medicina · doi:10.3390/medicina61050816 · Cited by 12
“The VExUS score is calculated in a stepwise manner, beginning with the measurement of IVC diameter, followed by Doppler waveform analysis of intra-abdominal veins if the IVC suggests congestion (Figure 3) [109].”
2026 ESC Guidelines on cardiac rehabilitation
Bäck, M., Wilhelm, M., Marcin, T., Machado, F. V. C., Sandberg, A., Buccheri, S., Conde, A. C., Czapla, M., Rosa, S. D., Gibson, I., et al. (2026) · European Heart Journal · doi:10.1093/eurheartj/ehag099 · Cited by 27
How to Use Natriuretic Peptides in Patients with Heart Failure with Non-Reduced Ejection Fraction?
Çelik, A. (2023) · The Anatolian Journal of Cardiology · doi:10.14744/anatoljcardiol.2023.3297 · Cited by 12
Diuretic Strategies in Acute Decompensated Heart Failure: A Narrative Review
Wilson, B., & Bates, D. (2024) · The Canadian Journal of Hospital Pharmacy · doi:10.4212/cjhp.3323 · Cited by 12
Mignone, J., Alexander, K. M., Dobbles, M., Eberst, K., Fonarow, G. C., & Ellenbogen, K. A. (2024) · Heart Rhythm O2 · doi:10.1016/j.hroo.2024.01.004 · Cited by 13
Metadata
- Authors
- Mebazaa, A., Davison, B., Chioncel, O., Cohen-Solal, A., Diaz, R., Filippatos, G., Metra, M., Ponikowski, P., Sliwa, K., Voors, A. A., Edwards, C., Novosadova, M., Takagi, K., Damasceno, A., Saidu, H., Gayat, E., Pang, P. S., Celutkiene, J., & Cotter, G.
- Affiliations
- Inserm (FR)
- Carol Davila University of Medicine and Pharmacy (RO)
- National and Kapodistrian University of Athens (GR)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Wroclaw Medical University (PL)
- University of Cape Town (ZA)
- University Medical Center Groningen (NL)
- Momentum Research (US)
- Eduardo Mondlane University (MZ)
- Bayero University Kano (NG)
- Indiana University Indianapolis (US)
- Corresponding author
- Mebazaa, Alexandre
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2022-12
- Volume
- 400
- Issue
- 10367
- Pages
- 1938-1952
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W4308471536
- Cited by
- 1,123
- References
- 32
- Citations by year
- 2026: 293 · 2025: 311 · 2024: 289 · 2023: 223 · 2022: 6
- FWCI
- 144.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 182 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- The Lancet (acceptedVersion)
- PubMed (publishedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- HAL (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Funders
- Roche Diagnostics Corp
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- acute heart failure, guideline-directed medical therapy, high-intensity care, heart failure readmission, all-cause mortality, NT-proBNP, left ventricular ejection fraction, outpatient monitoring, hospital discharge, drug safety and tolerability, heart failure pharmacotherapy
- MeSH terms
- Mineralocorticoid Receptor Antagonists, Female, Heart Failure, Humans, Male, Middle Aged, Quality of Life, Stroke Volume, Ventricular Function, Left, Treatment Outcome
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