دورية أكاديمية
Safety, tolerability and efficacy of rapid optimization, helped by NT-proBNP and GDF-15, of heart failure therapies (STRONG-HF): rationale and design for a multicentre, randomized, parallel-group study.
| العنوان: | Safety, tolerability and efficacy of rapid optimization, helped by NT-proBNP and GDF-15, of heart failure therapies (STRONG-HF): rationale and design for a multicentre, randomized, parallel-group study. |
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| المؤلفون: | Kimmoun, Antoine, Cotter, Gad, Davison, Beth, Takagi, Koji, Addad, Faouzi, Čelutkienė, Jelena, Chioncel, Ovidiu, Solal, Alain Cohen, Diaz, Rafael, Damasceno, Albertino, Duengen, Hans-Dirk, Filippatos, Gerasimos, Goncalvesova, Eva, Merai, Imad, Metra, Marco, Ponikowski, Piotr, Privalov, Dmitry, Sliwa, Karen, Sani, Mahmoud Umar, Voors, Adriaan A., Shogenov, Zaur, Mebazaa, Alexandre |
| المصدر: | European journal of heart failure, Hoboken : John Wiley and Sons Ltd, 2019, vol. 21, iss. 11, p. 1459-1467 ; ISSN 1388-9842 ; eISSN 1879-0844 |
| سنة النشر: | 2019 |
| المجموعة: | LAEI VL (Lithuanian Institute of Agrarian Economics Virtual Library) / LAEI VB (Lietuvos agrarinės ekonomikos institutasvirtualią biblioteką) |
| مصطلحات موضوعية: | Acute heart failure, Biomarker, Cardiovascular mortality, Rehospitalization |
| الوصف: | Aims Patients admitted for acute heart failure (HF) are at high risk of readmission and death, especially in the 90 days following discharge. We aimed to assess the safety and efficacy of early optimization of oral HF therapy with beta-blockers (BB), angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) or angiotensin receptor-neprilysin inhibitors (ARNi), and mineralocorticoid receptor antagonists (MRA) on 90-day clinical outcomes in patients admitted for acute HF. Methods In a multicentre, randomized, open-label, parallel-group study, a total of 900 patients will be randomized in a 1:1 ratio to either 'usual care' or 'high-intensity care'. Patients enrolled in the usual care arm will be discharged and managed according to usual clinical practice at the site. In the high-intensity care arm, doses of oral HF medications - including a BB, ACEi or ARB, and MRA - will be up-titrated to 50% of recommended doses before discharge and to 100% of recommended doses within 2 weeks of discharge. Up-titration will be delayed if the patients develop worsening symptoms and signs of congestion, hyperkalaemia, hypotension, bradycardia, worsening of renal function or significant increase in N-terminal pro-B-type natriuretic peptide between visits. The primary endpoint is 90-day all-cause mortality or HF readmission. Conclusions STRONG-HF is the first study to assess whether rapid up-titration of evidence-based guideline-recommended therapies with close follow-up in a large cohort of patients discharged from an acute HF admission is safe and can affect adverse outcomes during the first 90 days after discharge. Clinical Trial Registration: NCT03412201. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | http://vu.lvb.lt/VU:ELABAPDB43160484&prefLang=en_USTest |
| الإتاحة: | https://doi.org/10.1002/ejhf.1575Test http://vu.lvb.lt/VU:ELABAPDB43160484&prefLang=en_USTest |
| رقم الانضمام: | edsbas.6E504BCA |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |