# STRONG-HF: optitratie effectief over het hele EF-spectrum na HF-opname

*geplaatst 2023-06-06 · Hartfalen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2023.03.426 · https://hartvaat.nl/2023/06/06/strong-hf-optitratie-effectief-over-het-hele-ef-spectrum-na-hf-opname/*

Subanalyse van STRONG-HF toonde dat snelle optitratie van hartfalenmedicatie na opname effectief was over het hele EF-spectrum, inclusief HFpEF. Dit verbreedt de aanbeveling voor intensieve optitratie naar alle hartfalenfenotypen.

## English: Uptitrating Treatment After Heart Failure Hospitalization Across the Spectrum of Left Ventricular Ejection Fraction.

This STRONG-HF subanalysis showed that rapid up-titration of guideline-directed therapy after heart failure hospitalization was effective across the entire ejection fraction spectrum, including patients with HFpEF. The results expanded the aggressive post-discharge optimization approach beyond HFrEF.

## Abstract (original, from the publication)

BACKGROUND: Acute heart failure (AHF) is associated with a poor prognosis regardless of left ventricular ejection fraction (LVEF). STRONG-HF showed the efficacy and safety of a strategy of rapid uptitration of oral treatment for heart failure (HF) and close follow-up (high-intensity care), compared with usual care, in patients recently hospitalized for AHF and enrolled independently from their LVEF. OBJECTIVES: In this study, we sought to assess the impact of baseline LVEF on the effects of high-intensity care vs usual care in STRONG-HF. METHODS: The STRONG-HF trial enrolled patients hospitalized for AHF with any LVEF and not treated with full doses of renin-angiotensin inhibitors, beta-blockers, and mineralocorticoid receptor antagonists. High-intensity care with uptitration of oral medications was performed independently from LVEF. The primary endpoint was the composite of HF rehospitalization or all-cause death at day 180. RESULTS: Among the 1,078 patients randomized, 731 (68%) had LVEF ≤40% and 347 (32%) had LVEF >40%. The treatment benefit of high-intensity care vs usual care on the primary endpoint was consistent across the whole LVEF spectrum (interaction P with LVEF as a continuous variable = 0.372). Mean difference in the EQ-5D visual analog scale change from baseline to day 90 between treatment arms was slightly greater at higher LVEF values, but with no interaction between LVEF as a continuous variable and the treatment strategy (interaction P = 0.358). Serious adverse events were also independent from LVEF. CONCLUSIONS: Rapid uptitration of oral medications for HF and close follow-up reduce 180-day death and HF rehospitalization after AHF hospitalization independently from LVEF. (Safety, Tolerability and Efficacy of Rapid Optimization, Helped by NT-ProBNP Testing, of Heart Failure Therapies [STRONG-HF]; NCT03412201).

Auteurs: Matteo Pagnesi, Marco Metra, Alain Cohen-Solal, Christopher Edwards, Marianna Adamo, Daniela Tomasoni, Carolyn S P Lam, Ovidiu Chioncel, Rafael Diaz, Gerasimos Filippatos, Piotr Ponikowski, Karen Sliwa, Adriaan A Voors, Antoine Kimmoun, Maria Novosadova, Koji Takagi, Marianela Barros, Albertino Damasceno, Hadiza Saidu, Etienne Gayat, Peter S Pang, Jelena Celutkiene, Gad Cotter, Alexandre Mebazaa, Beth Davison

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2023.03.426. Bijgewerkt 2026-07-03T13:29:29Z. 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.