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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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In the citing paper
“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]
Experimental — accuracy not yet measuredIn the citing paper
“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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Fókuszban a csökkent ejekciós frakciójú szívelégtelenség gyógyszeres kezelése
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“The STRONG-HF [15] trial proposed the implementation of triple therapy (ACEIs, ARMs, and BBs) at the end of the AHF episode, reaching maximum doses within two weeks of discharge.”
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“In addition, a randomised controlled trial on the efficacy and safety of early introduction of standard treatment drugs showed significant outcomes in the intensive treatment group (i.e., the group in which guideline-directed medical therapy [GDMT] was introduced early and up-titrated early) [20].”
BackgroundIn-hospital evolution of secondary mitral regurgitation in acutely decompensated heart failure
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“These findings are reas-suring, especially given persistent calls for initiating and uptitrating multiple medications at the time of a hospitalization for adults with HF—an approach recently shown in the STRONG-HF trial to improve 180-day outcomes [24] and supported by guidelines [25].”
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“33 Several metrics of congestion, including a clinical congestion score, were significantly improved in the STRONG-HF study and led to smaller daily doses of loop diuretics at day 90 in the high-intensity care (HIC) group.”
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“Of note, the diuretic doses were lower at 90 and 180 days in the high intensity group [22].”
BackgroundThe ‘Peptide for Life’ Initiative in the Emergency Department Study
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MethodSelf-citationAcute heart failure – an EFIM guideline critical appraisal and adaptation for internists
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Coronary Artery Disease and Heart Failure
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“It could be argued that these drugs should have been initiated more rapidly, as recent literature recommends rapid initiation and up-titration in the first 6 weeks of hospital discharge [4,29].”
A contemporary review on heart failure with improved ejection fraction
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“Such therapeutic optimization is not confined to diuretic adaptation but also supports the titration of GDMT, which not only exerts intrinsic decongestive effects on its own but, above all, also modifies disease trajectories and directly influences clinical outcomes [ 62, 63].”
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“21,22”
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Self-citationContemporary Management of Acute Heart Failure
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Orter, S., Hametner, B., Mayer, C. C., Wassertheurer, S., Kaniušas, E., Danninger, K., Binder, R. K., Argyris, A., Protogerou, A. D., & Weber, T. (2026) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00036.2026 · Cited by 3
Jeemon, P., Ganapathi, S., Anikkady, N., Ismail, S., Unni, G., Bahuleyan, C. G., Meera, R., Daniel, R., Joseph, S., Paul, G. J., et al. (2026) · Circulation · doi:10.1161/circulationaha.126.082490 · Cited by 3
Holistic approach to drug therapy in a patient with heart failure
Forsyth, P., Beezer, J., & Bateman, J. (2023) · Heart · doi:10.1136/heartjnl-2022-321764 · Cited by 4
Girerd, N., Leclercq, C., Hanon, O., Bayés‐Genís, A., Januzzi, J. L., Damy, T., Lequeux, B., Meune, C., Sabouret, P. F., & Roubille, F. (2023) · Revista Española de Cardiología · doi:10.1016/j.recesp.2023.02.020 · Cited by 3
Heart Failure with Reduced Ejection Fraction and COVID-19, when the Sick Get Sicker
Contreras, J., Tinuoye, E. O., Folch, A., Aguilar, J., Free, K., Ilonze, O. J., Mazimba, S., Rao, R. A., & Breathett, K. K. (2023) · Cardiology Clinics · doi:10.1016/j.ccl.2023.06.006 · Cited by 3
New insights in acute heart failure
Asakage, A., Mebazaa, A., & Deniau, B. (2023) · La Presse Médicale · doi:10.1016/j.lpm.2023.104184 · Cited by 3
Self-citationRichard, J., Sama, J. N., Onwuanyi, A., & Ilonze, O. J. (2023) · Journal of the National Medical Association · doi:10.1016/j.jnma.2023.11.008 · Cited by 3
López‐Vilella, R., Trenado, V. J. D., Cervera, B. G., Sánchez-Lázaro, I. J., Martínez‐Dolz, L., & Bonet, L. A. (2024) · BMC Cardiovascular Disorders · doi:10.1186/s12872-024-03728-y · Cited by 3
“It should be noted that the only randomized clinical trial in this regard is the STRONG HF TRIAL, in which the SGLT2i pharmacological group was not included [25].”
BackgroundImpact of polypharmacy on 3-year mortality in patients with heart failure: a retrospective study
Hayashi, D., Kubota, Y., Nishino, T., Watanabe, Y., Iwade, Y., Matsuda, J., Kato, K., Tara, S., Ise, Y., Iwasaki, Y., et al. (2024) · Journal of Pharmaceutical Health Care and Sciences · doi:10.1186/s40780-024-00357-7 · Cited by 3
“Additionally, recent reports have also indicated that prompt introduction of GDMT by up-titration in heart failure treatment may help ameliorate heart failure symptoms, improve quality of life, and reduce the risk of re-hospi-talisation and mortality [22].”
BackgroundYan, C. L., Snipelisky, D., Velez, M., Baran, D. A., Estep, J. D., Bauerlein, E. J., & Rivera, N. T. (2024) · American Heart Journal Plus Cardiology Research and Practice · doi:10.1016/j.ahjo.2024.100438 · Cited by 3
“The STRONG-HF trial is one of the most recent clinical trials evaluating GDMT use, and its protocol directed achievement of half target doses of GDMT prior to discharge in patients hospitalized for acute HF and full target doses at 2 weeks post-discharge [24].”
MethodBhatty, A., Wilkinson, C., Batra, G., Aktaa, S., Smith, A. B., Wahab, A., Chappell, S., Alfredsson, J., Erlinge, D., Ferreira, J., et al. (2024) · European Heart Journal - Quality of Care and Clinical Outcomes · doi:10.1093/ehjqcco/qcae086 · Cited by 3
“18 , 19 Nonetheless, translating clinical guidelines into real world practice can be challenging.”
Griné, M., Guerreiro, C., Costa, F. M., Menezes, M. N., Ladeiras‐Lopes, R., Ferreira, D., & Santos, M. O. (2024) · Revista Portuguesa de Cardiologia · doi:10.1016/j.repc.2024.08.009 · Cited by 5
Deprescribing strategies in older patients with heart failure
Tersalvi, G., Beltrani, V., Peronti, M., Furlan, L., Foy, A., & Biasco, L. (2024) · Internal and Emergency Medicine · doi:10.1007/s11739-024-03791-5 · Cited by 4
“…Safety, Tolerability and Efficacy of Rapid Optimization, Helped by NT-proBNP Testing, of Heart Failure Therapies (STRONG-HF) trial showed that a high-intensity protocol for rapid GDMT up-titration significantly decreased 180-day risk of all-cause death or HF readmission compared to usual care [39].”
Accurate diagnosis of heart failure and improved perioperative outcomes
Deniau, B., Léopold, V., & Mebazaa, A. (2024) · British Journal of Anaesthesia · doi:10.1016/j.bja.2024.10.003 · Cited by 3
Self-citationDiuretic strategies in acute decompensated heart failure
Lo, K. B., & Nohria, A. (2024) · Heart Failure Reviews · doi:10.1007/s10741-024-10473-z · Cited by 3
Residual Risk of Adverse Kidney and Cardiovascular Outcomes in Patients with CKD
Khan, M. S., Rashid, A. M., Shafi, T., Rangaswami, J., Cherney, D. Z. I., & Butler, J. (2024) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.0000000588 · Cited by 3
Rode, F., Pavlović, N., Jordan, A., Radić, M., Lisičić, A., Tomić, S. S., Kursar, J., Manola, Š., & Jurin, I. (2025) · Heart and Vessels · doi:10.1007/s00380-025-02525-7 · Cited by 3
“The SGLT2I have a proven rapid onset of action in terms of reducing rehospitalizations and mortality for acute HF [16].”
Ye, L., Chang, A. J., Chioncel, O., Antohi, E., Geavlete, O. D., Abdelhamid, M., Adamo, M., Biegus, J., Chopra, V., Cotter, G., et al. (2025) · Heart Failure Reviews · doi:10.1007/s10741-025-10515-0 · Cited by 3
“Furthermore, not only was the high-intensity care group associated with more effective decongestion in the immediate post-discharge period but it was also associated with sustained decongestion post-discharge compared to usual care [32, 33, 67].”
InfluentialSelf-citationRambarat, P. K., DeVore, A. D., Bhatt, A. S., Allen, L. A., McIlvennan, C. K., Cotter, G., Mukhopadhyay, A., Ahmad, T., Ahmad, F. S., & Psotka, M. A. (2025) · JACC Heart Failure · doi:10.1016/j.jchf.2025.02.023 · Cited by 3
Self-citationLouca, A., Thomas, D., Odefjord, K., Genead, R., Backelin, C. N., Ljungman, C. E. A., Skoglund, K., Bollano, E., Rawshani, A., Sjöland, H., et al. (2025) · European Heart Journal - Digital Health · doi:10.1093/ehjdh/ztaf062 · Cited by 3
“12 At the same time, home-based monitoring (HBM) is gaining attention as a strategy to optimize heart failure treatment.”
Sekiya, Y., Fujiki, S., Tsuchiya, H., Kashimura, T., Okura, Y., Kodera, K., Watanabe, H., Takahashi, K., Bannai, S., Hatano, T., et al. (2025) · Circulation Journal · doi:10.1253/circj.cj-25-0200 · Cited by 3
CHAPMAN, B., Albert, N. M., Zajichek, A., Steinel, E., Baran, D. A., Svensson, L. G., Cho, L., Kapadia, S. R., Hohman, J. A., Rothman, R. E., et al. (2025) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2025.06.012 · Cited by 3
STRONG-HF Evidence for Proactive, Patient-Centered Prescribing
Allen, L. A., Thompson, J. S., & Stehlik, J. (2023) · JAMA Cardiology · doi:10.1001/jamacardio.2023.4565 · Cited by 3
Peripartum cardiomyopathy: the challenge of predicting cardiac function recovery
Basic, C., & Schaufelberger, M. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae111 · Cited by 3
Shiraishi, Y., Ikemura, N., Urashima, M., Kohno, T., Nakano, S., Tanaka, T. D., Nagatomo, Y., Ikoma, T., Ono, T., Numasawa, Y., et al. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-076519 · Cited by 4
“10 However, the trial did not specify a particular sequence for adjusting the dosage of each drug, and the use of SGLT2is was infrequent.”
BackgroundAsada, K., Saito, Y., Goto, H., Yaginuma, H., Sato, T., Hashimoto, O., Kitahara, H., & Kobayashi, Y. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13092501 · Cited by 3
“…approach of rapid up-titration of guideline-directed medical therapy resulted in better outcomes in hospitalized HF patients, as shown in a recent randomized trial [13], timely risk stratification is clinically important, and subsequent medical intervention may benefit patients with acute MI.”
BackgroundHow to Change the Medical History of Patients with Heart Failure and Recurrent Hospitalizations?
Andrade, F. A., Monferdini, L., & Vieira, J. L. (2023) · ABC Heart Failure & Cardiomyopathy · doi:10.36660/abchf.20230092 · Cited by 3
Effects of serial NT-proBNP measurements in patients with acute decompensated heart failure
Boesing, M., Bierreth, F., Abig, K., Giezendanner, S., Leuppi-Taegtmeyer, A. B., Lüthi-Corridori, G., Maier, S., Züsli, S., Leuppi, J. D., & Dieterle, T. (2024) · Global Cardiology Science and Practice · doi:10.21542/gcsp.2024.31 · Cited by 3
“Rapid up-titration was also found to be safe and led to a more prominent decrease in NT-proBNP levels compared to care as usual 28 .”
BackgroundČelutkienė, J., Čerlinskaitė‐Bajorė, K., Cotter, G., Edwards, C., Adamo, M., Arrigo, M., Barros, M., Biegus, J., Chioncel, O., Solal, A. C., et al. (2024) · Clinical Research in Cardiology · doi:10.1007/s00392-024-02518-y · Cited by 3
Self-citationLee, W., Lee, K., Rismiati, H., & Lee, H. (2024) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2024.088 · Cited by 3
“According to the STRONG-HF study, an intensive treatment strategy of rapid up-titration of GDMT after an acute HF admission reduced symptoms, improved quality of life, and reduced the risk of death or HF readmission [19].”
Weeks, K. L., & Bernardo, B. C. (2025) · Heart Lung and Circulation · doi:10.1016/j.hlc.2024.11.021 · Cited by 3
Eligibility and GDMT up-titration success in heart failure: A real-world assessment
Weidenhammer, A., Prausmüller, S., Stadler, M., Panagiotides, N. G., Spinka, G., Heitzinger, G., Arfsten, H., Strunk, G., Barkhudaryan, A., Partsch, C., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0323952 · Cited by 3
“Similarly to previous investigations [10–12], we have defined cut-offs in line with the convention for each clinical feature, which is termed an up-titration limiting factor.”
InfluentialTakahashi, T., Kusunose, K., Imai, T., Furukawa, Y., Okada, T., Kadokami, T., Kanzaki, Y., Matsuda, H., Mizukoshi, K., Kida, K., et al. (2025) · European Heart Journal - Cardiovascular Pharmacotherapy · doi:10.1093/ehjcvp/pvaf061 · Cited by 3
“28,29 However, in real-world clinical practice, high-intensity treatment is often challenging due to tolerability concerns.”
The year in cardiovascular medicine 2022: the top 10 papers in heart failure and cardiomyopathies
de Boer, R. A., & Bauersachs, J. K. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehac781 · Cited by 3
“A second study addressing this pressing issue was the Safety, Tolerability and Efficacy of Rapid Optimization, Helped by NT-proBNP testinG, of Heart Failure Therapies (STRONG-HF; NCT03412201).(10) STRONG-HF randomized patients who were admitted to the hospital with AHF, who were not treated with full doses of guidelin…”
BackgroundSystems of care for heart failure: bridging the divide between primary care and specialist services
Morton, G., & Moore, J. (2023) · Heart · doi:10.1136/heartjnl-2022-321757 · Cited by 3
The War Against Heart Failure Hospitalizations
Mastoris, I., Gupta, K., & Sauer, A. J. (2023) · Cardiology Clinics · doi:10.1016/j.ccl.2023.06.001 · Cited by 3
Rapid Uptitration: What's the Evidence?
Beldhuis, I. E., Voors, A. A., & Tromp, J. (2022) · European Journal of Heart Failure · doi:10.1002/ejhf.2759 · Cited by 3
Self-citationKittleson, M. M. (2023) · JACC Heart Failure · doi:10.1016/j.jchf.2022.11.019 · Cited by 3
Galati, G., Андреевна, Г. О., Pedretti, R. F. E., & Ambrosio, G. (2023) · International Journal of Cardiology · doi:10.1016/j.ijcard.2023.131118 · Cited by 3
Overcoming Vulnerability in Heart Failure: Transitional Tactical Toughness
Castagna, F., Simitsis, P., & Mehra, M. R. (2023) · European Journal of Heart Failure · doi:10.1002/ejhf.3054 · Cited by 3
Madaudo, C., Bromage, D. I., & Cannata, A. N. (2025) · Future Cardiology · doi:10.1080/14796678.2025.2490403 · Cited by 4
Heart failure: the need for cardiologist-guided follow-up to improve outcomes
Lund, L. H. (2025) · European Heart Journal · doi:10.1093/eurheartj/ehaf229 · Cited by 3
The Art and Science of Congestion Diagnosis and Management in Heart Failure
Borovac, J. A., & Miric, D. (2025) · Cardiac failure review · doi:10.15420/cfr.2025.53 · Cited by 3
Bauersachs, J. K., & Soltani, S. (2026) · European Heart Journal · doi:10.1093/eurheartj/ehag198 · Cited by 3
Song, D. D., Bayshtok, S., Shah, V., Jaiswal, V., Seo, A., & Rubinstein, D. (2023) · Radiology Case Reports · doi:10.1016/j.radcr.2023.10.055 · Cited by 2
“This emphasizes the importance of early initiation of GDMT to ensure as per STRONG-HF trial which can help limit cardiovascular remodeling to prevent atrial dilatation and severe MR and as a result prevent left recurrent laryngeal nerve palsy [15] .”
2023 Updated European Society of Cardiology guidelines on heart failure
Rakisheva, A., & Kuanyshbekova, R. (2024) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2024-5841 · Cited by 2
SGLT2 inhibitors across the acute cardiac care spectrum: insights and perspectives
Bertaina, M., Galluzzo, A., Carbonaro, C., Marzulli, A., Calcagnile, C., Sbarra, P., Franchin, L., Boccuzzi, G. G., & Iannaccone, M. (2025) · Future Cardiology · doi:10.1080/14796678.2025.2503666 · Cited by 2
Uptitration of Sacubitril/Valsartan in Acute Heart Failure: Insight from the PREMIER Study
DOI, S., Tanaka, A., Kida, K., Imai, T., Ueda, Y., NAKANO, Y., Kizaki, Y., Fukuda, D., Matsue, Y., Akashi, Y. J., et al. (2025) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2025.05.001 · Cited by 2
Khan, M. S., Sauer, A. J., Green, C. L., McDermott, J., Khan, M. S., Chaudhry, S., Haghighat, A. R., Bennett, M. K., Martyn, T., Shah, H., et al. (2025) · American Heart Journal · doi:10.1016/j.ahj.2025.06.001 · Cited by 2
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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