Eligibility for rapid up-titration of guideline-directed medical therapy of real-world patients hospitalised for heart failure
Introduction and aims: The 2023 Focused Update of the 2021 ESC Heart Failure (HF) Guidelines recommends the rapid up-titration (RT) of guideline-directed medical therapy (GDMT) for all patients hospitalised for HF to improve prognosis in light of STRONG-HF trial. However, the real-world feasibility...
Elmentve itt :
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| Dokumentumtípus: | Cikk |
| Megjelent: |
2025
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| Sorozat: | CARDIOLOGY
150 No. 5 |
| Tárgyszavak: | |
| doi: | 10.1159/000543070 |
| mtmt: | 35653099 |
| Online Access: | http://publicatio.bibl.u-szeged.hu/35430 |
| Tartalmi kivonat: | Introduction and aims: The 2023 Focused Update of the 2021 ESC Heart Failure (HF) Guidelines recommends the rapid up-titration (RT) of guideline-directed medical therapy (GDMT) for all patients hospitalised for HF to improve prognosis in light of STRONG-HF trial. However, the real-world feasibility of RT and the optimal selection of suitable patients may cause difficulties, as the STRONG-HF trial applied strict randomisation criteria. We aimed to assess the proportion of hospitalised HF patients suitable for RT after discharge.Methods: The proportion of patients eligible for RT based on the basic in- and exclusion criteria of the STRONG-HF trial (systolic blood pressure [SBP]≥100mmHg, heart rate [HR]≥60min-1, serum potassium≤5mmol/L, eGFR≥30mL/min/1.73m2, discharge NT-proBNP>1500pg/mL) was assessed in a consecutive patient cohort at a tertiary referral center between 01/04/2021 and 31/12/2023. Results: Data from 408 consecutive patients were analysed (male: 71%; age: 62[51-72]years; left ventricular ejection fraction: 27[20-35]%; HFrEF: 82%; hypertension: 67%; diabetes: 36%; atrial fibrillation: 47%). 78% of the patients were suitable for RT based on the SBP criterion, 93% on HR, 89% on serum potassium, and 91% on eGFR values. Thus, 60% were eligible for RT using the combined assessment of these parameters. When including the NT-proBNP value as well (60%), 34% of the cohort were eligible for RT.Conclusions: Based on our study, the proportion of patients suitable for RT of GDMT ranged from 34% to 60% based on the basic eligibility indicators of the STRONG-HF trial. Our results highlight the strategic importance of careful selection of patients eligible for RT. |
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| Terjedelem/Fizikai jellemzők: | 500-510 |
| ISSN: | 0008-6312 |