STRONG-HF: Fast Optimal GDMT Cuts Deaths, Hospitalizations in Acute HF

High-intensity management of acute heart failure (HF), involving swiftly starting and optimizing oral HF medications followed by regular check-ins and NT-proBNP monitoring after hospital discharge, cuts the rate of all-cause death and HF readmissions within 3 months, according to top-line results from the STRONG-HF trial.

The sponsor, Heart Initiative, announced the trial’s premature close last week, after its data and safety monitoring board (DSMB) recommended early termination. An interim analysis, done after 90-day follow-up in 1,000 patients, had pointed to a significantly lower risk of all-cause death or HF readmissions in the high-intensity arm as compared to the usual-care arm.

“The decision was made after discussion with the study's executive committee, the study PI (Dr. Alexandre Mebazaa) and the Coordinating Center (Momentum Research, Durham, NC, represented by Dr. Gad Cotter and Dr. Beth Davison),” the announcement states.

The investigator-initiated trial had originally been designed to enroll 1,800 patients with a follow-up of 180 days. Full results are slated for presentation at next month’s American Heart Association Scientific Sessions.

According to the press release, guideline-recommended oral HF medications for acute HF patients in the "high intensity care" arm were uptitrated to half optimal doses at the time of hospital discharge then to full optimal doses by 2 weeks postdischarge, “with safety visits 1 week after any uptitration and follow-up visits at 6 weeks and 3 months. At each visit, patients were assessed by physical examination for congestion and blood tests including NT-proBNP measurements.”