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

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'Why we do What we do in Cardiology'

Bishnu Subedi

35 episodes

4 days ago

I am Dr. Bishnu Subedi. I am a cardiologist in the United States. In the era of evidence-based medicine, our practice is usually guided by a scientific study, expert society statements, or clinical guidelines. In this podcast series, I intend to highlight some of these practice-changing articles in the field of cardiology from past and present.

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

'Why we do What we do in Cardiology'

5 minutes 29 seconds

1 year ago

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