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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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Kresoja, K., Adamo, M., Rommel, K., Stolz, L., Karam, N., Giannini, C., Melica, B., von Bardeleben, R. S., Butter, C., Horn, P., et al. (2024) · ESC Heart Failure · doi:10.1002/ehf2.14705 · Cited by 11
“With recent evidence showing that GDMT dosing and up-titration is a crucial prognostic factor for HFrEF patients, 9 the need for a tool to assess GDMT becomes evident.”
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“28 Moreover, TRED-HF (Therapy Withdrawal in Recovered Dilated Cardiomyopathy-Heart Failure) trial was the first randomized trial to demonstrate the effect of HF drugs, consisting of beta blockers, RASI, and MRA, in patients deemed to have recovered dilated cardiomyopathy, reinforcing the importance…”
BackgroundProximal versus distal diuretics in congestive heart failure
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“The STRONG-HF trial demonstrated that, compared to usual care, high-intensity treatment strategies employing rapid implementation and up-titration of guideline-directed therapies, resulted in greater reductions in congestion and incidence of hospital readmission following discharge [103 ].”
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“41 45 Issues related to low HR, low BP and renal dysfunction contribute to failure of GDT implementation.”
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“…in patients with worsening HF, which occurs when symptoms of chronic HF escalate, thereby requiring urgent treatment adjustments such as intravenous diuretics or hospitalization, the benefits of this strategy in the specific group of older and complex patients are not well clarified [6–8].”
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“29 However, its applicability and adoption in clinical practice, beyond the context of a clinical trial, is less known.”
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“…STRONG-HF trial highlighted this potential, demonstrating a significantly reduced risk of HF readmission, and alleviated symptoms when guideline-directed medical therapy was uptitrated within 2 weeks of discharge, alongside monitoring of the clinical status and evaluation of laboratory values [53].”
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“42 They were used in conjunction with standard physical examination (e.g., blood pressure, heart rate) and laboratory measures (e.g., serum potassium and kidney function) to help up-titrate beta blockers, inhibitors of the renin-angiotensin aldosterone system and loop diuretics.”
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“20,2 1 The present document builds on previous data by discussing the availability of specific management resources for patients with acute or advanced HF, as well as the provision of appropriate transition of care and post-discharge follow-up, both of which have significant prognostic implications in HF. 22 Despite a…”
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“One should take notice of the recently published STRONG-HF trial [22].”
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“Recently, the STRONG-HF trial demonstrated the implementation of class I indication drugs after HF discharge (although it did not consider SGLT2i), reaching at least 50% of the maximum dose, with a rapid dosing protocol, is possible and is accompanied by a better short-term prognosis [26].”
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“38,39) Translating scientific evidence into routine clinical practice remains a challenge worldwide ( Figure 4 ).”
BackgroundPotential effects of beta-blockers in HFpEF
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“5 The diuretic and decongestant effects of GDMT was specifically evaluated for each component.”
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“…intensive treatment strategy of rapid uptitration of guide-line-directed medication within 2 weeks from discharge, and close follow-up after an acute HF admission, improved quality of life and reduced symptoms and the risk of 180-day all-cause death or HF readmission compared with usual care [33].”
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Self-citationSex differences in diagnosis and treatment of heart failure: toward precision medicine
Lee, S. Y., & Park, S. (2025) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2024.338 · Cited by 10
“The “four pillar-therapy” is well established in HFrEF, and titrating these therapies within 4 weeks is related to better prognosis [4,28].”
Bozkurt, B., Müllens, W., Leclercq, C., Russo, A. M., Savarese, G., Böhm, M., Hill, L., Kinugawa, K., Sato, N., Abraham, W. T., et al. (2025) · European Journal of Heart Failure · doi:10.1002/ejhf.3641 · Cited by 10
Self-citationFujimoto, Y., Kitai, T., Horiuchi, Y., Kondo, T., Murai, R., Matsukawa, R., Abe, T., & Matsue, Y. (2025) · Circulation Journal · doi:10.1253/circj.cj-24-1020 · Cited by 9
Yau, K., Cherney, D. Z. I., & Odutayo, A. (2025) · Diabetes Obesity and Metabolism · doi:10.1111/dom.70044 · Cited by 9
“23 While the trial found that rapid institution of GDMT reduced the primary outcome of heart failure readmission and death, this occurred irrespective of the baseline NT-proBNP level.”
Targeting the NO–sGC–cGMP Pathway: Mechanisms of Action of Vericiguat in Chronic Heart Failure
Bajec, T., & Poglajen, G. (2025) · Cells · doi:10.3390/cells14171400 · Cited by 9
Salah, H. M., Ambrosy, A. P., Biegus, J., Bocchi, E. A., Butler, J., Chioncel, O. D., Cotter, G., Davison, B. A., Dzudié, A., Freund, Y., et al. (2025) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2025.09.020 · Cited by 10
Self-citationLindberg, F., Uijl, A., Benson, L., Valente, V., Coats, A. J. S., Bohm, M., Metra, M., Masi, S., Lund, L. H., Rosano, G. M. C., et al. (2026) · European Heart Journal · doi:10.1093/eurheartj/ehag199 · Cited by 10
“Furthermore, following STRONG-HF, 20 the 2023 focused update of the ESC HF guidelines strengthened the emphasis on rapid treatment intensification pre-and post-discharge among patients hospitalized for HF. 21 Finally, our cohort consisted of patients with HFrEF enrolled in a quality registry predominantly reflecting s…”
Self-citationKardiologische Rehabilitation bei Patienten mit Herzinsuffizienz
Schwaab, B., Henke, N., Guha, M., Schlitt, A., Müller‐Werdan, U., Edelmann, F., von Haehling, S., Landmesser, U., & Pauschinger, M. (2023) · Die Kardiologie · doi:10.1007/s12181-023-00611-6 · Cited by 9
Olson, M., Thompson, Z., Xie, L. X., & Nair, A. P. (2023) · Current Cardiology Reports · doi:10.1007/s11886-023-01907-5 · Cited by 7
Kerwagen, F., Riemer, U., Wachter, R., von Haehling, S., Abdin, A., Böhm, M., Schulz, M., & Störk, S. (2023) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2023.100778 · Cited by 10
“15,16 Recently, the STRONG-HF trial supported this concept as it demonstrated the bene fi t and safety of an intensi fi ed, early up-titration of GDMT. 17 However, the implementation of GDMT for patients with HFrEF into daily medical practice faces major barriers.”
MethodNew Challenges in Heart Failure with Reduced Ejection Fraction: Managing Worsening Events
Lavalle, C., Lullo, L. D., Jabbour, J. P., Palombi, M., Trivigno, S., Mariani, M. V., Summaria, F., Severino, P., Badagliacca, R., Miraldi, F., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12226956 · Cited by 10
Medical Management and Device-Based Therapies in Chronic Heart Failure
Nguyen, A. H., Hurwitz, M., Abraham, J. A., Blumer, V. L., Flanagan, M. C., Garan, A. R., Kanwar, M. K., Kataria, R., Kennedy, J. L. W., Kochar, A., et al. (2023) · Journal of the Society for Cardiovascular Angiography & Interventions · doi:10.1016/j.jscai.2023.101206 · Cited by 10
Muk, B., Bánfi‐Bacsárdi, F., Vámos, M., Pilecky, D., Majoros, Z., Török, G., Vágány, D., Polgár, B., Solymossi, B., Borsányi, T., et al. (2024) · Diagnostics · doi:10.3390/diagnostics14020131 · Cited by 9
“According to the results of recently published data and our analysis, HFOC greatly impacts the implementation and continuous optimisation of novel GDMT [38,39].”
BackgroundResultInfluentialHigh-intensity care for GDMT titration
Biegus, J., Pagnesi, M., Davison, B. A., Ponikowski, P. P., Mebazaa, A., & Cotter, G. (2024) · Heart Failure Reviews · doi:10.1007/s10741-024-10419-5 · Cited by 9
“In STRONG-HF, rapid GDMT up-titration after hospitalization for acute HF was coupled with close follow-up to ensure patient safety during the process of medical therapy optimization [51, 52].”
BackgroundMethodInfluentialSelf-citationThe Role of Congestion Biomarkers in Heart Failure with Reduced Ejection Fraction
Correale, M., Fioretti, F., Tricarico, L., Croella, F., Brunetti, N. D., Inciardi, R. M., Mattioli, A. V., & Nodari, S. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12113834 · Cited by 9
“These may allow to for the identification of high- and very-high risk patients, in which it would be preferable to start a very close outpatient follow-up, by referring the patient to an HF clinic and to pursue an intensive treatment strategy, such as the one tested in the STRONG-HF trial [115].”
Management of Heart Failure in Hospitalized Patients
Kittleson, M. M. (2023) · Annals of Internal Medicine · doi:10.7326/aitc202312190 · Cited by 10
Pascual-Figal, D. A., Vicente, Á. H., Pastor‐Pérez, F. J., Martínez‐Sellés, M., Solé‐González, E., Garcia, J. A., García‐Pavía, P., Roman, A. V., Sanchez, P. L., Delgado, J. F., et al. (2024) · European Journal of Heart Failure · doi:10.1002/ejhf.3222 · Cited by 8
“11 In the NICE study, clinical follow-up visits were the same for both arms (three within the first 90days), which may have limited a more substantial impact on clinical events.”
Tereshchenko, S. N., Жиров, И. В., Uskach, T. M., Saidova, M. A., Sp, G., Rimskaya, E. M., Николаевна, Н. С., Narusov, O. Y., Safiullina, A. A., Tereshchenko, A. S., et al. (2024) · Eurasian heart journal · doi:10.38109/2225-1685-2024-2-6-76 · Cited by 8
General physicians' perspectives on SGLT2 inhibitors for heart failure
Teng, L. E., Lammoza, N., Aung, A. K., Thayaparan, A., Vasudevan, S., Edwards, G., Hormiz, M., Gibbs, H. H., & Hopper, I. (2024) · Internal Medicine Journal · doi:10.1111/imj.16440 · Cited by 8
“26 This highlights the important role that general practitioners play in prescribing and up titrating HF medications, which should be further harnessed with shared models of care in HF 27 and effective transitions of care from hospital to community settings.”
Burgos, L. M., Ballari, F., Spaccavento, A., Ricciardi, B., Suárez, L. L., Vila, R. C. B., Bortoli, M. A. D., Conde, D. G., & Díez, M. (2024) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2024.102779 · Cited by 9
Outcomes and Complications of Mitral and Tricuspid Transcatheter Edge-to-edge Repair
Arnautovic, J. Z., Ya’qoub, L., Wajid, Z., Jacob, C., Murlidhar, M., Damlakhy, A., & Walji, M. (2024) · Interventional Cardiology Reviews Research Resources · doi:10.15420/icr.2024.08 · Cited by 8
Vianini, E., Pandey, A., Rolland, C., Ngubane, N., Müller‐Wieland, D., Gilbert, J. D., & Alhussein, A. (2025) · Diabetes Therapy · doi:10.1007/s13300-025-01725-8 · Cited by 10
Current Practice of Guideline-Directed Medical Therapy After Acute Heart Failure Hospitalization
Kanaoka, K., Iwanaga, Y., Takegawa, K., Fujimoto, W., Nishioka, Y., Myojin, T., Okada, K., Noda, T., Imamura, T., & Miyamoto, Y. (2025) · JACC Asia · doi:10.1016/j.jacasi.2025.01.015 · Cited by 8
Diuretic De-Escalation in Response to HF Therapy
Biegus, J., Cotter, G., Davison, B. A., Metra, M., Pagnesi, M., & Ponikowski, P. P. (2025) · JACC Heart Failure · doi:10.1016/j.jchf.2025.03.010 · Cited by 10
Self-citationChen, J., Xiao, R., Gao, L., Zhou, Y., Qin, S., Wang, Y., Feng, P., Gu, J., Pu, P., Jiang, D., et al. (2025) · International Journal of Cardiology · doi:10.1016/j.ijcard.2025.133367 · Cited by 8
Adamo, M., Pagnesi, M., Marsan, N. A., Bauersachs, J. K., Hausleiter, J., Zieroth, S. R., & Metra, M. (2025) · European Heart Journal · doi:10.1093/eurheartj/ehaf480 · Cited by 10
Self-citationInam, M., Sangrigoli, R., Ruppert, L., Saiganesh, P., & Hamad, E. A. (2025) · Journal of Cardiovascular Development and Disease · doi:10.3390/jcdd12080302 · Cited by 8
“The STRONG-HF trial further supported early and aggressive titration, showing a reduction in 180-day mortality and HF readmissions when therapy was initiated during hospitalization and intensified post discharge [40].”
Naidu, A. S., Ambrosy, A. P., Cotter, G., Bocchi, E. A., Butler, J., Chioncel, O. D., Davison, B. A., Dzudié, A., Freund, Y., Fudim, M., et al. (2025) · ESC Heart Failure · doi:10.1002/ehf2.15389 · Cited by 10
Self-citationAcute Heart Failure Care – a Consensus Series of an International Experts' Group
Cotter, G., Biegus, J., Fudim, M., Miró, Ò., Ambrosy, A. P., Pagnesi, M., Chioncel, O., Davison, B. A., Freund, Y., Bocchi, E. A., et al. (2025) · European Journal of Heart Failure · doi:10.1002/ejhf.70057 · Cited by 8
Self-citationTassell, B. W. V., Golino, M., Canada, J. M., Markley, R., Billingsley, H., Buono, M. G. D., Talasaz, A. H., THOMAS, G. K., Chiabrando, J. G., Wohlford, G. F., et al. (2025) · Circulation Heart Failure · doi:10.1161/circheartfailure.125.013546 · Cited by 11
Time to Quadruple Therapy After Initial Diagnosis of Heart Failure With Reduced Ejection Fraction
Jacobs, J. A., Greene, T., Vanneman, M. E., Kean, J. T., Carter, S. J., Shah, K. S., Pandey, A., Derington, C. G., Zheutlin, A. R., Fang, J., et al. (2026) · JAMA Cardiology · doi:10.1001/jamacardio.2026.0375 · Cited by 9
Polypill for heart failure with reduced ejection fraction: the POLY-HF randomized trial
Pandey, A., Keshvani, N., Rizvi, S. K., Khashami, F., Yaros, K., Usman, M., Segar, M. W., Jain, A. K., Coellar, J. D., Bustillo-Rubio, M., et al. (2026) · Nature Medicine · doi:10.1038/s41591-026-04504-5 · Cited by 8
“The magnitudes of benefit are similar to those observed in the STRONG-HF trial, which evaluated rapid uptitration of GDMT versus usual care 8 .”
Núñez‐Marín, G., Iraola-Viana, D., Lorenzo, M., de la Espriella, R., Villar, S., Santas, E., Miñana, G., Sanchís, J. M., Carratalá, A., Miró, Ò., et al. (2023) · Expert Review of Molecular Diagnostics · doi:10.1080/14737159.2023.2216386 · Cited by 8
“Compared with usual care, the intensive strategy was associated with a higher proportion of patients up-titrated to full doses of GDMT, a greater decrease in NT-proBNP at 90 days, an improvement in symptoms and quality of life, and a reduction of the risk of all-cause death or heart failure readmission with similar ra…”
MethodBak, M., & Choi, J. (2023) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2023.223 · Cited by 8
“223 high-intensity care group, which titrated up to the target dose within 2 weeks after hospital discharge, with a usual care group and demonstrated a 34% reduction in HF readmission or all-cause death events in the high-intensity care group [24].”
BackgroundMethodCotter, G., Davison, B. A., Adams, K. F., Ambrosy, A. P., Atabaeva, L. S., Beavers, C. J., Bhatt, A. S., Givertz, M. M., Grodin, J. L., Lala, A., et al. (2023) · European Journal of Heart Failure · doi:10.1002/ejhf.3109 · Cited by 8
Self-citationAvances en insuficiencia cardiaca
Zamorano, J. L., & Leal, A. G. (2024) · Medicina Clínica · doi:10.1016/j.medcli.2023.12.026 · Cited by 8
Shoji, S., & Mentz, R. J. (2024) · Heart Failure Reviews · doi:10.1007/s10741-024-10412-y · Cited by 10
“Clinicians are now in an era focused on how to initiate and titrate quad-rable therapy in the early phase of the disease trajectory, including during heart failure (HF) hospitalization [3, 4].”
Tiwari, D., & Aw, T. C. (2024) · Diagnostics · doi:10.3390/diagnostics14192251 · Cited by 9
Farmakis, D. T., Tromp, J., Marinaki, S., Ouwerkerk, W., Angermann, C. E., Bistola, V., Dahlström, U., Dickstein, K., Ertl, G., Ghadanfar, M. M., et al. (2023) · European Journal of Heart Failure · doi:10.1002/ejhf.2833 · Cited by 9
“Higher prescription of guideline-directed medical therapies (GDMT) at discharge has been associated with better short and long-term outcomes in HF patients, while the initiation and rapid titration of GDMT before and shortly after discharge is feasible, and safe (20,21,22).”
BackgroundMethodSelf-citationLee, M. M. Y., & Sattar, N. A. (2023) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15085 · Cited by 11
“of GDMT and close follow-up after an acute HF admission reduced symptoms, improved QoL and reduced the risk of 180-day all-cause death or HF readmission compared with usual care.(41) The EMPULSE trial lends”
BackgroundCotter, G., & Davison, B. A. (2023) · European Journal of Heart Failure · doi:10.1002/ejhf.2916 · Cited by 8
Self-citationMan, J. P., Dijkgraaf, M. G. W., Handoko, M. L., de Lange, F. J., Winter, M. M., Schijven, M. P., Stienen, S., Meregalli, P. G., Kok, W. E. M., Kuipers, D. I., et al. (2023) · ESC Heart Failure · doi:10.1002/ehf2.14634 · Cited by 8
Latest pharmaceutical approaches across the spectrum of heart failure
Bismpos, D., Wintrich, J., Hoevelmann, J., & Böhm, M. (2024) · Heart Failure Reviews · doi:10.1007/s10741-024-10389-8 · Cited by 11
“Furthermore, the early HF therapy is associated with improved quality of life [91].”
BackgroundMethodInfluentialSTRONG-HF and Implementing Heart Failure Therapies: Godspeed … With Care
Butler, J., Talha, K. M., & Fonarow, G. C. (2023) · Circulation · doi:10.1161/circulationaha.122.063811 · Cited by 8
Digital health in heart failure: Empowering physicians to enhance patient care
Fortuni, F., Tavazzi, L., & Ciliberti, G. (2024) · International Journal of Cardiology · doi:10.1016/j.ijcard.2024.132261 · Cited by 8
Time to SGLT2 Inhibitors Initiation in Patients With Heart Failure
Moon, J., Udell, J. A., Chong, A. S., Fang, J., Austin, P. C., Ko, D. T., Stukel, T. A., Atzema, C. L., Booth, G. L., Tu, K., et al. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.032296 · Cited by 8
Early Initiation of Guideline-Directed Medical Therapy for Heart Failure After Cardiac Surgery
Schwann, A. N., Jaffe, L. M., Givertz, M. M., Wood, K. L., & Engelman, D. T. (2024) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2024.05.034 · Cited by 7
Early Heart Failure Outcomes and Medical Therapy Use in a Virtually Managed Hospital at Home Setting
Martyn, T., Patolia, H. H., Platek, N., Tang, R., Albert, N. M., Crow, D. R., Vest, A. R., Kapadia, S. R., Dweik, R. A., Svensson, L. G., et al. (2024) · JACC Heart Failure · doi:10.1016/j.jchf.2024.10.007 · Cited by 7
Abe, T., Shirotani, S., Takada, T., Yoshida, A., Hasegawa, S., Kishihara, M., Fukushima, N., Saito, K., Yamaguchi, J., & Jujo, K. (2024) · Journal of the Renin-Angiotensin-Aldosterone System · doi:10.1177/14703203241306037 · Cited by 8
“23 The trial demonstrated that this intensive treatment strategy reduced symptoms, improved quality of life, and lowered the risk of mid-term all-cause mortality or HF readmission compared to usual care.”
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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