Thread by @MHBeasleyMD

In my opinion, the biggest news from #AHA22 for the heart failure community was the results of #STRONGHF. @AlexMebazza, the trial's principal investigator, presented the results. The following thread summarizes his presentation. @AHAScience

#STRONGHF was conducted to determine whether rapid/high-intensity uptitrations of doses of heart failure #GDMT would be safe and effective compared with usual care. @AlexMebazaa @AHAScience #AHA22

Patients received high-intensity care resulting in the successful administration of beta-blockers, RAS inhibitors, & mineralocorticoid receptor antagonists w/in 6 weeks. The primary outcome was hospitalization for HF or all-cause mortality w/in 180 days. @AlexMebazaa #AHA22

Approximately 50% of patients in the intervention arm were on full optimal doses of BB and RASi at 90 days, while more than 80% of patients were on full optimal doses of MRA at 90 days. As compared to the usual care, this was significantly better. @AlexMebazaa @AHAScience #AHA22

More than 80% of the patients in the intervention arm received half to full optimal doses of BB, RASi, and MRA after 90 days. Among those taking usual care, only MRA was administered at the same dose and frequency. @AlexMebazaa @AHAScience #AHA22

High-intensity care resulted in less edema, a lower NYHA class, and a lower natriuretic peptide level, among other outcomes - all without a significant difference in renal function. @AlexMebazaa @AHAScience #AHA22

As the primary endpoint, an absolute reduction of 8.1% in HF readmissions and all-cause mortality was observed between high intensity and usual care at 180 days. @AlexMebazaa @AHAScience #AHA22

In the absence of deaths due to COVID, the absolute risk reduction increased to 8.9%. In addition, when looking at all-cause mortality, the curves began to split 60 days after randomization. @AlexMebazaa @AHAScience #AHA22

It was observed that high-intensity care achieved the primary end-point regardless of LVEF, i.e., <40 or >40. @AlexMebazaa @AHAScience #AHA22

The rapid up-titration of HF therapies under close follow-up reduces HF hospitalizations, reduces the risk of all-cause mortality, and improves the quality of life of patients living with #heartfailure. @AlexMebazaa @AHAScience #AHA22