Can Rapid Uptitration of Neurohormonal Therapies After Acute Heart Failure Treat Congestion?

In a secondary analysis of the STRONG-HF trial, an intensive approach achieved decongestion more often than usual care.

As the evidence base for heart failure (HF) pharmacotherapy has expanded, strategies to achieve target doses of evidence-based therapies (EBTs) more promptly have also proliferated. The manufacturer-sponsored STRONG-HF trial showed that a rapid, intensive approach to uptitrating EBT doses after an acute heart failure hospitalization resulted in a lower risk for the primary composite endpoint of death or heart failure hospitalization within 6 months (Lancet 2022; 400:1938). This secondary analysis assessed the impact of intensive dose escalation on the signs and symptoms of decongestion.

The open-label trial included nearly 1100 individuals randomized to usual care or early and rapid uptitration of neurohormonal blockers during additional pos…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, MACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)