# GUIDE-HF en de impact van COVID-19 op hartfalenuitkomsten

*geplaatst 2022-07-14 · Hartfalen · European heart journal · doi 10.1093/eurheartj/ehac114 · https://hartvaat.nl/2022/07/14/guide-hf-en-de-impact-van-covid-19-op-hartfalenuitkomsten/*

Analyse van de GUIDE-HF-trial toonde dat de COVID-19-pandemie een significante invloed had op hartfalenuitkomsten, met veranderingen in zorggebruik en eventrates. De pandemie maskeerde het potentiële voordeel van PA-drukmonitoring en benadrukt het belang van pandemiecorrectie in trials.

## English: The GUIDE-HF trial of pulmonary artery pressure monitoring in heart failure: impact of the COVID-19 pandemic.

This GUIDE-HF analysis demonstrated that the COVID-19 pandemic significantly influenced heart failure event rates, confounding the trial's primary results and highlighting the importance of accounting for pandemic effects in contemporary cardiovascular trial interpretation.

## Abstract (original, from the publication)

AIMS: During the coronavirus disease 2019 (COVID-19) pandemic, important changes in heart failure (HF) event rates have been widely reported, but few data address potential causes for these changes; several possibilities were examined in the GUIDE-HF study. METHODS AND RESULTS: From 15 March 2018 to 20 December 2019, patients were randomized to haemodynamic-guided management (treatment) vs. control for 12 months, with a primary endpoint of all-cause mortality plus HF events. Pre-COVID-19, the primary endpoint rate was 0.553 vs. 0.682 events/patient-year in the treatment vs. control group [hazard ratio (HR) 0.81, P = 0.049]. Treatment difference was no longer evident during COVID-19 (HR 1.11, P = 0.526), with a 21% decrease in the control group (0.536 events/patient-year) and no change in the treatment group (0.597 events/patient-year). Data reflecting provider-, disease-, and patient-dependent factors that might change the primary endpoint rate during COVID-19 were examined. Subject contact frequency was similar in the treatment vs. control group before and during COVID-19. During COVID-19, the monthly rate of medication changes fell 19.2% in the treatment vs. 10.7% in the control group to levels not different between groups (P = 0.362). COVID-19 was infrequent and not different between groups. Pulmonary artery pressure area under the curve decreased -98 mmHg-days in the treatment group vs. -100 mmHg-days in the controls (P = 0.867). Patient compliance with the study protocol was maintained during COVID-19 in both groups. CONCLUSION: During COVID-19, the primary event rate decreased in the controls and remained low in the treatment group, resulting in an effacement of group differences that were present pre-COVID-19. These outcomes did not result from changes in provider- or disease-dependent factors; pulmonary artery pressure decreased despite fewer medication changes, suggesting that patient-dependent factors played an important role in these outcomes. Clinical Trials.gov: NCT03387813.

Auteurs: Michael R Zile, Akshay S Desai, Maria Rosa Costanzo, Anique Ducharme, Alan Maisel, Mandeep R Mehra, Sara Paul, Samuel F Sears, Frank Smart, Christopher Chien, Ashrith Guha, Jason L Guichard, Shelley Hall, Orvar Jonsson, Nessa Johnson, Poornima Sood, John Henderson, Philip B Adamson, JoAnn Lindenfeld

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehac114. Bijgewerkt 2026-07-03T13:28:56Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.