Acute CHF: GDMT Up-titration After Hospitalization for Acute HF (STRONG-HF Trial)
'Why we do What we do in Cardiology'19 Jan 2024

Acute CHF: GDMT Up-titration After Hospitalization for Acute HF (STRONG-HF Trial)

Study: STRONG-HF trial examined rapid up-titration of heart failure medications (GDMT) after hospitalization.

Goal: Reach optimal GDMT doses within 2 weeks after discharge.

Findings:

Over 90% of patients achieved medium-to-high GDMT doses within 2 weeks.

Patients with lower blood pressure, more congestion, and higher risk markers received less up-titration.

Higher GDMT doses:

Associated with lower rates of readmission or death for heart failure within 6 months.

Led to greater improvements in quality of life.

Were safe and well-tolerated.

Implications:

Efforts should be made to quickly reach optimal GDMT doses for most patients after hospitalization for heart failure.

Individual factors like blood pressure and congestion may influence up-titration.

This approach offers potential benefits for improving outcomes and quality of life.

Note: This study focused on three main GDMT classes (RAAS inhibitors, beta-blockers, MRAs). Newer drugs like SGLT2 inhibitors were not included but might also benefit from early initiation. Further research is needed on their effectiveness in this context.


Link: doi:10.1001/jamacardio.2023.4553

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