Choosing the Best Treatment Strategy for Acute Heart Failure

Intensive vasodilator therapy demonstrated no benefits over usual care

While evidence-based strategies to treat chronic heart failure (HF) with reduced systolic function are plentiful, effective therapies for acute decompensated HF (ADHF) are not, with trials of novel vasodilators showing negative results. In an open-label, randomized study (NCT00512759), researchers assessed the impact of an intensive vasodilator strategy using traditional agents versus guideline-based usual care in 788 patients hospitalized with acute HF (median age, 78; 37% women, median blood pressure [BP], 131/75 mm Hg; left ventricular ejection fraction [LVEF] <0.40, 53%).

Intensive vasodilator treatment was as follows:

Day 1: sublingual nitrates followed by transdermal nitrates, plus low-dose oral hydralazine
Day 2: up-titrated nitrates, c…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, 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)