Safety, Tolerability and Efficacy of Rapid Optimization, Helped by NT-proBNP testinG, of Heart Failure Therapies
NCT ID: NCT03412201
Last Updated: 2021-02-12
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
UNKNOWN
Clinical Phase
NA
Total Enrollment
1800 participants
Study Classification
INTERVENTIONAL
Study Start Date
2018-05-11
Study Completion Date
2021-10-31
Brief Summary
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STRONG-HF is a multicenter, randomized, parallel group study designed to evaluate the efficacy and safety of up-titration of standard oral heart failure medications during hospitalization for acute heart failure. Patients admitted for acute heart failure will be randomized within 2 days before discharge to either usual care or intensification of treatment with a beta-blocker, a renin-angiotensin system blocker, and a mineralocorticoid receptor blocker ("high intensity care" arm). In the "high intensity care" arm, patients' clinical signs and symptoms of heart failure will be assessed, and routine laboratory measures and biomarkers will be measured, at frequent post-discharge visits. When these measures indicate that it is safe to do so, the doses of the oral heart failure medications will be increased to optimal levels. Patients will be followed through 180 days from randomization. Patients assigned to the usual care group will be followed by their general physician and/or cardiologist according to local medical standards. Patients who were screened but did not meet eligibility criteria will be followed for 90-day outcome. Randomized patients will be contacted at 180 days to assess outcomes.
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Detailed Description
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STRONG-HF is a multicenter, randomized, parallel group study designed to evaluate the efficacy and safety of up-titration of standard of care medical therapy including beta-blockers; angiotensin converting enzyme inhibitors (ACEi), angiotensin receptor blocker (ARB) or angiotensin receptor neprolysin inhibitor (ARNi); and mineralocorticoid receptor antagonist (MRAs), on morbidity and mortality when initiated and up-titrated early during hospitalization for acute heart failure (AHF). Optimal safety conditions will allow physicians to introduce and/or continue oral HF therapies during this "vulnerable phase" in AHF patients. Patients admitted for AHF with clinical signs of congestion and elevated circulating N-terminal pro-B-type natriuretic peptide (NT-proBNP) and who are not treated with optimal doses of oral heart failure (HF) therapies within 2 days before hospital discharge for AHF and who are hemodynamically stable will be randomized in a 1:1 ratio to either usual care (named "usual care" arm) or intensification of treatment with beta-blockers, and ACEi (or ARB) or ARNi and a MRA (named "high intensity care" arm). In the latter arm, repeated assessments of clinical signs and symptoms of heart failure, routine clinical laboratory measures including potassium, sodium, and creatinine as well as NT-ProBNP will foster, encourage and ensure the safety of the optimization of oral heart failure therapies. AHF patients who were screened but did not meet inclusion criteria, including low circulating NT-proBNP at visit 2, will be followed for 90-day outcome. Randomized patients will be contacted at 180 days to assess outcomes.
Conditions
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Heart Failure
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
multicenter, randomized, parallel group study
Primary Study Purpose
TREATMENT
Blinding Strategy
NONE
Study Groups
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Usual Care
Follow-up and management of heart failure medications provided by the patient's general physician and/or cardiologist according to local medical standards
Group Type
ACTIVE_COMPARATOR
Usual Care
Intervention Type
OTHER
Follow-up and management of heart failure medications provided by the patient's general physician and/or cardiologist according to local medical standards
High Intensity Care
Follow-up and management of heart failure medications provided by specialists at participating institutions. Doses of oral heart failure medications optimized within 2 weeks, provided clinical assessments and laboratory measures indicate that it is safe to increase doses.
Group Type
EXPERIMENTAL
High Intensity Care
Intervention Type
OTHER
Follow-up and management of heart failure medications provided by specialists at participating institutions. Doses of oral heart failure medications optimized within 2 weeks, provided clinical assessments and laboratory measures indicate that it is safe to increase doses.
Interventions
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Usual Care
Follow-up and management of heart failure medications provided by the patient's general physician and/or cardiologist according to local medical standards
Intervention Type
OTHER
High Intensity Care
Follow-up and management of heart failure medications provided by specialists at participating institutions. Doses of oral heart failure medications optimized within 2 weeks, provided clinical assessments and laboratory measures indicate that it is safe to increase doses.
Intervention Type
OTHER
Eligibility Criteria
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Inclusion Criteria
1. Hospital admission within the 72 hours prior to Screening for acute heart failure with dyspnea at rest and pulmonary congestion on chest X-ray, and other signs and/or symptoms of heart failure such as edema and/or positive rales on auscultation.
2. All measures within 24 hours prior to Randomization of systolic blood pressure ≥ 100 mmHg, and of heart rate ≥ 60 bpm.
3. All measures within 24 hours prior to Randomization of serum potassium ≤ 5.0 mEq/L (mmol/L).
4. Biomarker criteria for persistent congestion:
5. At Screening, NT-proBNP \> 2,500 pg/mL.
6. At the time of Randomization (within 2 days prior to discharge), NT-proBNP \> 1,500 pg/mL (to ensure the persistence of congestion) that has decreased by more than 10% compared to Screening (to ensure the acuity of the index episode).
7. At 1 week prior to admission, at Screening, and at Visit 2 (just prior to Randomization) either (a) \<= ½ the optimal dose of ACEi/ARB/ARNi (see Table) prescribed, no beta-blocker prescribed, and \<= ½ the optimal dose of MRA prescribed or (b) no ACEi/ARB/ARNi prescribed, \<= ½ the optimal dose of beta-blocker prescribed, and \<= ½ the optimal dose of MRA prescribed.
8. Written informed consent to participate in the study.
2. All measures within 24 hours prior to Randomization of systolic blood pressure ≥ 100 mmHg, and of heart rate ≥ 60 bpm.
3. All measures within 24 hours prior to Randomization of serum potassium ≤ 5.0 mEq/L (mmol/L).
4. Biomarker criteria for persistent congestion:
5. At Screening, NT-proBNP \> 2,500 pg/mL.
6. At the time of Randomization (within 2 days prior to discharge), NT-proBNP \> 1,500 pg/mL (to ensure the persistence of congestion) that has decreased by more than 10% compared to Screening (to ensure the acuity of the index episode).
7. At 1 week prior to admission, at Screening, and at Visit 2 (just prior to Randomization) either (a) \<= ½ the optimal dose of ACEi/ARB/ARNi (see Table) prescribed, no beta-blocker prescribed, and \<= ½ the optimal dose of MRA prescribed or (b) no ACEi/ARB/ARNi prescribed, \<= ½ the optimal dose of beta-blocker prescribed, and \<= ½ the optimal dose of MRA prescribed.
8. Written informed consent to participate in the study.
Exclusion Criteria
1. Age \< 18 or \> 85 years.
2. Clearly documented intolerance to high doses of beta-blockers.
3. Clearly documented intolerance to high doses of renin-angiotensin system (RAS) blockers (both ACEi and ARB).
4. Mechanical ventilation \[not including continuous positive airway pressure (CPAP)/bilevel positive airway pressure (BIPAP)\] in the 24 hours prior to Screening.
5. Significant pulmonary disease contributing substantially to the patients' dyspnea such as forced expiratory volume during the 1st second (FEV1)\< 1 liter or need for chronic systemic or nonsystemic steroid therapy, or any kind of primary right heart failure such as primary pulmonary hypertension or recurrent pulmonary embolism.
6. Myocardial infarction, unstable angina or cardiac surgery within 3 months, or cardiac resynchronization therapy (CRT) device implantation within 3 months, or percutaneous transluminal coronary intervention (PTCI), within 1 month prior to Screening.
7. Index Event (admission for AHF) triggered primarily by a correctable etiology such as significant arrhythmia (e.g., sustained ventricular tachycardia, or atrial fibrillation/flutter with sustained ventricular response \>130 beats per minute, or bradycardia with sustained ventricular arrhythmia \<45 beats per minute), infection, severe anemia, acute coronary syndrome, pulmonary embolism, exacerbation of chronic obstructive pulmonary disease (COPD), planned admission for device implantation or severe non-adherence leading to very significant fluid accumulation prior to admission and brisk diuresis after admission. Troponin elevations without other evidence of an acute coronary syndrome are not an exclusion.
8. Uncorrected thyroid disease, active myocarditis, or known amyloid or hypertrophic obstructive cardiomyopathy.
9. History of heart transplant or on a transplant list, or using or planned to be implanted with a ventricular assist device.
10. Sustained ventricular arrhythmia with syncopal episodes within the 3 months prior to screening that is untreated.
11. Presence at Screening of any hemodynamically significant valvular stenosis or regurgitation, except mitral or tricuspid regurgitation secondary to left ventricular dilatation, or the presence of any hemodynamically significant obstructive lesion of the left ventricular outflow tract.
12. Active infection at any time during the AHF hospitalization prior to Randomization based on abnormal temperature and elevated white blood cells (WBC) or need for intravenous antibiotics.
13. Stroke or transient ischemic attack (TIA) within the 3 months prior to Screening.
14. Primary liver disease considered to be life threatening.
15. Renal disease or estimated glomerular filtration rate (eGFR) \< 30 mL/min/1.73m2 \[as estimated by the simplified Modification of Diet in Renal Disease (MDRD) formula\] at Screening or history of dialysis.
16. Psychiatric or neurological disorder, cirrhosis, or active malignancy leading to a life expectancy \< 6 months.
17. Prior (defined as less than 30 days from screening) or current enrollment in a congestive heart failure (CHF) trial or participation in an investigational drug or device study within the 30 days prior to screening
18. Discharge for the AHF hospitalization anticipated to be \> 14 days from admission, or to a long-term care facility. Randomization must occur within 12 days following admission and within 2 days prior to anticipated discharge.
19. Inability to comply with all study requirements, due to major co-morbidities, social or financial issues, or a history of noncompliance with medical regimens, that might compromise the patient's ability to understand and/or comply with the protocol instructions or follow-up procedures
20. Pregnant or nursing (lactating) women.
2. Clearly documented intolerance to high doses of beta-blockers.
3. Clearly documented intolerance to high doses of renin-angiotensin system (RAS) blockers (both ACEi and ARB).
4. Mechanical ventilation \[not including continuous positive airway pressure (CPAP)/bilevel positive airway pressure (BIPAP)\] in the 24 hours prior to Screening.
5. Significant pulmonary disease contributing substantially to the patients' dyspnea such as forced expiratory volume during the 1st second (FEV1)\< 1 liter or need for chronic systemic or nonsystemic steroid therapy, or any kind of primary right heart failure such as primary pulmonary hypertension or recurrent pulmonary embolism.
6. Myocardial infarction, unstable angina or cardiac surgery within 3 months, or cardiac resynchronization therapy (CRT) device implantation within 3 months, or percutaneous transluminal coronary intervention (PTCI), within 1 month prior to Screening.
7. Index Event (admission for AHF) triggered primarily by a correctable etiology such as significant arrhythmia (e.g., sustained ventricular tachycardia, or atrial fibrillation/flutter with sustained ventricular response \>130 beats per minute, or bradycardia with sustained ventricular arrhythmia \<45 beats per minute), infection, severe anemia, acute coronary syndrome, pulmonary embolism, exacerbation of chronic obstructive pulmonary disease (COPD), planned admission for device implantation or severe non-adherence leading to very significant fluid accumulation prior to admission and brisk diuresis after admission. Troponin elevations without other evidence of an acute coronary syndrome are not an exclusion.
8. Uncorrected thyroid disease, active myocarditis, or known amyloid or hypertrophic obstructive cardiomyopathy.
9. History of heart transplant or on a transplant list, or using or planned to be implanted with a ventricular assist device.
10. Sustained ventricular arrhythmia with syncopal episodes within the 3 months prior to screening that is untreated.
11. Presence at Screening of any hemodynamically significant valvular stenosis or regurgitation, except mitral or tricuspid regurgitation secondary to left ventricular dilatation, or the presence of any hemodynamically significant obstructive lesion of the left ventricular outflow tract.
12. Active infection at any time during the AHF hospitalization prior to Randomization based on abnormal temperature and elevated white blood cells (WBC) or need for intravenous antibiotics.
13. Stroke or transient ischemic attack (TIA) within the 3 months prior to Screening.
14. Primary liver disease considered to be life threatening.
15. Renal disease or estimated glomerular filtration rate (eGFR) \< 30 mL/min/1.73m2 \[as estimated by the simplified Modification of Diet in Renal Disease (MDRD) formula\] at Screening or history of dialysis.
16. Psychiatric or neurological disorder, cirrhosis, or active malignancy leading to a life expectancy \< 6 months.
17. Prior (defined as less than 30 days from screening) or current enrollment in a congestive heart failure (CHF) trial or participation in an investigational drug or device study within the 30 days prior to screening
18. Discharge for the AHF hospitalization anticipated to be \> 14 days from admission, or to a long-term care facility. Randomization must occur within 12 days following admission and within 2 days prior to anticipated discharge.
19. Inability to comply with all study requirements, due to major co-morbidities, social or financial issues, or a history of noncompliance with medical regimens, that might compromise the patient's ability to understand and/or comply with the protocol instructions or follow-up procedures
20. Pregnant or nursing (lactating) women.
Minimum Eligible Age
18 Years
Maximum Eligible Age
85 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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Hôpitaux Universitaires Saint-Louis-Lariboisière
UNKNOWN
Sponsor Role
collaborator
Momentum Research, Inc.
INDUSTRY
Sponsor Role
collaborator
Roche Diagnostics GmbH
INDUSTRY
Sponsor Role
collaborator
INSERM UMR-942, Paris, France
OTHER
Sponsor Role
collaborator
Heart Initiative
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Alexandre Mebazaa, MD PhD FESC
Role: PRINCIPAL_INVESTIGATOR
Inserm UMRS 942; Hôpitaux Universitaires Saint-Louis-Lariboisière, University Paris Diderot
Locations
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Sanatorio de la Canada
Villa María, Córdoba Province, Argentina
Site Status
RECRUITING
Chutro Srl Clinic
Córdoba, , Argentina
Site Status
RECRUITING
Del Prado Private Clinic
Córdoba, , Argentina
Site Status
RECRUITING
San Roque Hospital
Córdoba, , Argentina
Site Status
RECRUITING
Rosario Cardiovascular Institute
Rosario, , Argentina
Site Status
RECRUITING
Rosario Clinical Research Institute - Delta
Rosario, , Argentina
Site Status
RECRUITING
Modelo Cardiology Center
San Miguel de Tucumán, , Argentina
Site Status
RECRUITING
Diagnostic and Treatment Medical Clinic SA
Santa Fe, , Argentina
Site Status
RECRUITING
Santa Rosa Hospital
Santa Rosa, , Argentina
Site Status
RECRUITING
San Martin SA Clinic
Venado Tuerto, , Argentina
Site Status
RECRUITING
Fusavim Privada SRL Clinic
Villa María, , Argentina
Site Status
RECRUITING
Internal Med. 1, St. Josef Hospital Braunau
Braunau am Inn, , Austria
Site Status
TERMINATED
Clin. Dep. Internal Med 3, University Hospital St. Poelten
Sankt Pölten, , Austria
Site Status
TERMINATED
1. Med. Dep, Donauspital
Vienna, , Austria
Site Status
WITHDRAWN
Cardiology Department at Hietzing Hospital with Neurological Center Rosenhugel
Vienna, , Austria
Site Status
WITHDRAWN
Dep. Of Cardiology, Medical Univ. Vienna
Vienna, , Austria
Site Status
WITHDRAWN
Internal Med., LKH Villach
Villach, , Austria
Site Status
WITHDRAWN
Cardiovascular Diagnostic Center
Cartagena, Departamento de Bolívar, Colombia
Site Status
RECRUITING
CEQUIN Cardiomet Foundation
Armenia, Quindío Department, Colombia
Site Status
RECRUITING
Cardiomet Pereira Clinical Research Center Foundation
Pereira, Risaralda Department, Colombia
Site Status
RECRUITING
Santander Ophthalmological Foundation
Bucaramanga, Santander Department, Colombia
Site Status
RECRUITING
Auxerre Hospital Center
Auxerre, , France
Site Status
WITHDRAWN
University Hospital of Beziers
Béziers, , France
Site Status
WITHDRAWN
Center Hospital Regional University of Tours Trousseu Hospital
Chambray-lès-Tours, , France
Site Status
WITHDRAWN
University Hospital Henri Mondor
Creil, , France
Site Status
WITHDRAWN
CHU Dijon Burgundy F. Mitterand
Dijon, , France
Site Status
WITHDRAWN
Hôpitaux Universitaires Saint-Louis-Lariboisière, University Paris Diderot
Paris, , France
Site Status
WITHDRAWN
Center Hospital of Toulon
Toulon, , France
Site Status
WITHDRAWN
Buda Hospital of the Hospitaller Order of Saint John of God
Budapest, , Hungary
Site Status
TERMINATED
Kanizsai Dorottya Hospital
Nagykanizsa, , Hungary
Site Status
TERMINATED
St. Rafael Hospital in Zala County
Zalaegerszeg, , Hungary
Site Status
WITHDRAWN
Barzilay MC Ashkelon
Ashkelon, , Israel
Site Status
TERMINATED
Asaf Harofe MC
Ẕerifin, , Israel
Site Status
WITHDRAWN
Dept of Medicine Research unit, Maputo Central Hospital
Maputo, , Mozambique
Site Status
RECRUITING
Mavalane Hospital, National Institute of Health
Maputo, , Mozambique
Site Status
TERMINATED
Amino Kano Teaching Hospital
Kano, , Nigeria
Site Status
RECRUITING
Murtala Muhammad Specialist Hospital
Kano, , Nigeria
Site Status
RECRUITING
State Budget HealthCare Institution "First City clinical hospital named after E.E. Volosevich"
Arkhangelsk, , Russia
Site Status
RECRUITING
Regional budget Healthcare Institution "Cardiological dispensary"
Ivanovo, , Russia
Site Status
RECRUITING
Federal State Budget Educational Institution of Higher Education "Moscow State Medico-Dental University n.a. A.I. Evdokimov", under Ministry of Health of the Russian Federation
Moscow, , Russia
Site Status
RECRUITING
Federal State Budget Educational Institution of Higher Education "Moscow State University n.a. M.V. Lomonosov", independent division Medical research Educational Centre
Moscow, , Russia
Site Status
TERMINATED
Moscow City Hospital # 81, Moscow
Moscow, , Russia
Site Status
RECRUITING
Moscow State Budget Healthcare Institution City clinical Hospital 52 of Moscow Healthcare Department
Moscow, , Russia
Site Status
RECRUITING
Primary Healthcare Unit of the RF Ministry of Internal Affairs in Moscow
Moscow, , Russia
Site Status
TERMINATED
Russian National Research Medical University n.a. N.I.Pirogov based at City Clinical hospital n.a. V.M.Buyanov DZM
Moscow, , Russia
Site Status
RECRUITING
SBHI of Moscow City clinical hospital 64 of Moscow Healthcare department
Moscow, , Russia
Site Status
RECRUITING
State Budget HealthCare Institution of Moscow "City clinical hospital 15 n.a. O.M. Filatov under Department of HealthCare of Moscow"
Moscow, , Russia
Site Status
RECRUITING
State Budget HealthCare Institution of Moscow "City clinical hospital 29 n.a. N.E. Bauman under Department of HealthCare of Moscow"
Moscow, , Russia
Site Status
RECRUITING
State Budget HealthCare Institution of Mosocw "City clinical hospital 51 under Department of HealthCare of Moscow"
Moscow, , Russia
Site Status
RECRUITING
Saint-Petersburg State Budget HealthCare Institution "City hospital 38 n.a. N.A. Semashko"
Pushkin, , Russia
Site Status
TERMINATED
Municipal Government-financed Institution of Healthcare "City Emergency Hospital" of Rostov-on-Don City
Rostov-on-Don, , Russia
Site Status
RECRUITING
Federal State Budgetary Educational Institution of Higher Education "Ryazan State Medical University named after academician I.P. Pavlov"
Ryazan, , Russia
Site Status
RECRUITING
Federal State Budget Educational Institution of Higher Education "North-West state medical university n.a. I.I. Mechnikov under the Ministry of Health of the Russian Federation"
Saint Petersburg, , Russia
Site Status
TERMINATED
Saint Petersburg State Budget Healthcare Institution Pokrovskaya City Hospital
Saint Petersburg, , Russia
Site Status
TERMINATED
Saint-Petersburg State Budget Healthcare Institution City Hospital 15
Saint Petersburg, , Russia
Site Status
RECRUITING
State Budget Institution "Saint Petersburg state budget research institution of first aid named after I. I. Dzhanelidze"
Saint Petersburg, , Russia
Site Status
RECRUITING
State Budget HealthCare Institution of Vladimir Region "City Hospital 4 of Vladimir"
Vladimir, , Russia
Site Status
RECRUITING
State Institution of Healthcare of Yaroslavl Region "Clinical Hospital 8"
Yaroslavl, , Russia
Site Status
TERMINATED
National Institute of Cardio and Vascular Diseases
Bratislava, , Slovakia
Site Status
TERMINATED
V. Internal Clinic, LFUK and UNB Bratislava
Bratislava, , Slovakia
Site Status
TERMINATED
Internal Department, Hospital with Polyclinic Brezno
Brezno, , Slovakia
Site Status
TERMINATED
Internal Department, Dolnooravian Hospital of Dr. L.N.Jege
Dolný Kubín, , Slovakia
Site Status
TERMINATED
Internal Department, Hospital with Polyclinic Lucenec
Lučenec, , Slovakia
Site Status
TERMINATED
First Internal Clinic, Faculty Hospital with Polyclinic Nove Zamky
Nové Zámky, , Slovakia
Site Status
TERMINATED
Department of Internal Medicine Hospital Rimavska Sobota
Rimavská Sobota, , Slovakia
Site Status
TERMINATED
Department of Internal Medicine UVN SNP-FN
Ružomberok, , Slovakia
Site Status
TERMINATED
Internal Department, NsP Spisska Nova Ves
Spišská Nová Ves, , Slovakia
Site Status
TERMINATED
Internal Department Hospital Arm General L. Svobodu Svidnik
Svidník, , Slovakia
Site Status
TERMINATED
Groote Schuur Hospital
Cape Town, , South Africa
Site Status
TERMINATED
Nelson Mandela Academic Hospital, Walter Sisulu University
Mthatha, , South Africa
Site Status
TERMINATED
Habib Bougatfa Hospital
Bizerte, , Tunisia
Site Status
TERMINATED
Regional Hospital of Jendouba
Jendouba, , Tunisia
Site Status
TERMINATED
Fattouma Bourguiba Hospital
Monastir, , Tunisia
Site Status
TERMINATED
Hedi chaker Hospital
Sfax, , Tunisia
Site Status
TERMINATED
Charles Nicolle Hospital
Tunis, , Tunisia
Site Status
WITHDRAWN
Habib Thameur Hospital
Tunis, , Tunisia
Site Status
TERMINATED
La Rabta Hospital
Tunis, , Tunisia
Site Status
TERMINATED
Military Hospital
Tunis, , Tunisia
Site Status
WITHDRAWN
Countries
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Argentina
Austria
Colombia
France
Hungary
Israel
Mozambique
Nigeria
Russia
Slovakia
South Africa
Tunisia
Central Contacts
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Facility Contacts
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Miguel Angel Hominal
Role: primary
Fernando Gabriel Manzur Jattín
Role: primary
3157315055 ext. 57
Gregorio Sánchez Vallejo
Role: primary
3104527096 ext. 57
Luis Hernando Garcia Ortiz
Role: primary
3116111 ext. 57
Juan Diego Higuera Cobos
Role: primary
3162791839 ext. 57
References
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Zhang X, Davison B, Adamo M, Arrigo M, Biegus J, Chioncel O, Cohen Solal A, Cotter G, Edwards C, Kimmoun A, Lam CSP, Mebazaa A, Metra M, Novosadova M, Pang PS, Sliwa K, Takagi K, Voors AA, Ezekowitz JA. Guideline-Directed Medical Therapy Use in the STRONG-HF Trial. Circ Heart Fail. 2025 Sep;18(9):e012716. doi: 10.1161/CIRCHEARTFAILURE.124.012716. Epub 2025 Jul 3.
Reference Type
DERIVED
Myhre PL, Grupper A, Mebazaa A, Davison B, Edwards C, Takagi K, Adamo M, Arrigo M, Barros M, Biegus J, Celutkiene J, Cerlinskaite-Bajore K, Chioncel O, Cohen-Solal A, Damasceno A, Deniau B, Diaz R, Filippatos G, Gayat E, Kimmoun A, Ter Maaten JM, Metra M, Novosadova M, Pagnesi M, Pang PS, Ponikowski P, Saidu H, Sliwa K, Tomasoni D, Voors A, Cotter G, Lam CSP. Changes in Liver Function Tests, Congestion, and Prognosis After Acute Heart Failure: The STRONG-HF Trial. JACC Adv. 2025 Mar;4(3):101607. doi: 10.1016/j.jacadv.2025.101607. Epub 2025 Feb 21.
Reference Type
DERIVED
Farmakis D, Davison B, Fountoulaki K, Liori S, Chioncel O, Metra M, Celutkiene J, Cohen-Solal A, Damasceno A, Diaz R, Edwards C, Gayat E, Novosadova M, Bistola V, Pang PS, Ponikowski P, Saidu H, Sliwa K, Takagi K, Voors AA, Mebazaa A, Cotter G, Filippatos G. Rapid Uptitration of Guideline-Directed Medical Therapies in Acute Heart Failure With and Without Atrial Fibrillation. JACC Heart Fail. 2024 Nov;12(11):1845-1858. doi: 10.1016/j.jchf.2024.06.010. Epub 2024 Aug 14.
Reference Type
DERIVED
Arrigo M, Davison B, Edwards C, Adamo M, Ambrosy AP, Barros M, Biegus J, Celutkiene J, Cerlinskaite-Bajore K, Chioncel O, Cohen-Solal A, Damasceno A, Diaz R, Filippatos G, Gayat E, Kimmoun A, Lam CSP, Metra M, Novosadova M, Pagnesi M, Pang PS, Ponikowski P, Saidu H, Sliwa K, Takagi K, Ter Maaten JM, Tomasoni D, Voors AA, Cotter G, Mebazaa A. Characteristics, treatment, and outcomes of early vs. late enrollees of the STRONG-HF trial. Am Heart J. 2024 Aug;274:119-129. doi: 10.1016/j.ahj.2024.04.019. Epub 2024 May 12.
Reference Type
DERIVED
Ambrosy AP, Chang AJ, Davison B, Voors A, Cohen-Solal A, Damasceno A, Kimmoun A, Lam CSP, Edwards C, Tomasoni D, Gayat E, Filippatos G, Saidu H, Biegus J, Celutkiene J, Ter Maaten JM, Cerlinskaite-Bajore K, Sliwa K, Takagi K, Metra M, Novosadova M, Barros M, Adamo M, Pagnesi M, Arrigo M, Chioncel O, Diaz R, Pang PS, Ponikowski P, Cotter G, Mebazaa A. Titration of Medications After Acute Heart Failure Is Safe, Tolerated, and Effective Regardless of Risk. JACC Heart Fail. 2024 Sep;12(9):1566-1582. doi: 10.1016/j.jchf.2024.04.017. Epub 2024 May 12.
Reference Type
DERIVED
Celutkiene J, Cerlinskaite-Bajore K, Cotter G, Edwards C, Adamo M, Arrigo M, Barros M, Biegus J, Chioncel O, Cohen-Solal A, Damasceno A, Diaz R, Filippatos G, Gayat E, Kimmoun A, Leopold V, Metra M, Novosadova M, Pagnesi M, Pang PS, Ponikowski P, Saidu H, Sliwa K, Takagi K, Ter Maaten JM, Tomasoni D, Lam CSP, Voors AA, Mebazaa A, Davison B. Impact of Rapid Up-Titration of Guideline-Directed Medical Therapies on Quality of Life: Insights From the STRONG-HF Trial. Circ Heart Fail. 2024 Apr;17(4):e011221. doi: 10.1161/CIRCHEARTFAILURE.123.011221. Epub 2024 Mar 6.
Reference Type
DERIVED
Cotter G, Deniau B, Davison B, Edwards C, Adamo M, Arrigo M, Barros M, Biegus J, Celutkiene J, Cerlinskaite-Bajore K, Chioncel O, Cohen-Solal A, Damasceno A, Diaz R, Filippatos G, Gayat E, Kimmoun A, Lam CSP, Metra M, Novosadova M, Pang PS, Pagnesi M, Ponikowski P, Saidu H, Sliwa K, Takagi K, Ter Maaten JM, Tomasoni D, Voors A, Mebazaa A. Optimization of Evidence-Based Heart Failure Medications After an Acute Heart Failure Admission: A Secondary Analysis of the STRONG-HF Randomized Clinical Trial. JAMA Cardiol. 2024 Feb 1;9(2):114-124. doi: 10.1001/jamacardio.2023.4553.
Reference Type
DERIVED
Pagnesi M, Metra M, Cohen-Solal A, Edwards C, Adamo M, Tomasoni D, Lam CSP, Chioncel O, Diaz R, Filippatos G, Ponikowski P, Sliwa K, Voors AA, Kimmoun A, Novosadova M, Takagi K, Barros M, Damasceno A, Saidu H, Gayat E, Pang PS, Celutkiene J, Cotter G, Mebazaa A, Davison B. Uptitrating Treatment After Heart Failure Hospitalization Across the Spectrum of Left Ventricular Ejection Fraction. J Am Coll Cardiol. 2023 Jun 6;81(22):2131-2144. doi: 10.1016/j.jacc.2023.03.426.
Reference Type
DERIVED
Adamo M, Pagnesi M, Mebazaa A, Davison B, Edwards C, Tomasoni D, Arrigo M, Barros M, Biegus J, Celutkiene J, Cerlinskaite-Bajore K, Chioncel O, Cohen-Solal A, Damasceno A, Diaz R, Filippatos G, Gayat E, Kimmoun A, Lam CSP, Novosadova M, Pang PS, Ponikowski P, Saidu H, Sliwa K, Takagi K, Ter Maaten JM, Voors A, Cotter G, Metra M. NT-proBNP and high intensity care for acute heart failure: the STRONG-HF trial. Eur Heart J. 2023 Aug 14;44(31):2947-2962. doi: 10.1093/eurheartj/ehad335.
Reference Type
DERIVED
Cerlinskaite-Bajore K, Lam CSP, Sliwa K, Adamo M, Ter Maaten JM, Leopold V, Mebazaa A, Davison B, Edwards C, Arrigo M, Barros M, Biegus J, Chioncel O, Cohen-Solal A, Damasceno A, Diaz R, Filippatos G, Gayat E, Kimmoun A, Metra M, Novosadova M, Pagnesi M, Pang PS, Ponikowski P, Saidu H, Takagi K, Tomasoni D, Voors AA, Cotter G, Celutkiene J. Sex-specific analysis of the rapid up-titration of guideline-directed medical therapies after a hospitalization for acute heart failure: Insights from the STRONG-HF trial. Eur J Heart Fail. 2023 Jul;25(7):1156-1165. doi: 10.1002/ejhf.2882. Epub 2023 Jun 1.
Reference Type
DERIVED
Mebazaa A, Davison B, Chioncel O, Cohen-Solal A, Diaz R, Filippatos G, Metra M, Ponikowski P, Sliwa K, Voors AA, Edwards C, Novosadova M, Takagi K, Damasceno A, Saidu H, Gayat E, Pang PS, Celutkiene J, Cotter G. Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial. Lancet. 2022 Dec 3;400(10367):1938-1952. doi: 10.1016/S0140-6736(22)02076-1. Epub 2022 Nov 7.
Reference Type
DERIVED
Cotter G, Davison B, Metra M, Sliwa K, Voors AA, Addad F, Celutkiene J, Chioncel O, Cohen Solal A, Diaz R, Damasceno A, Duengen HD, Filippatos G, Goncalvesova E, Merai I, Ponikowski P, Privalov D, Sani MU, Takagi K, Shogenov Z, Saidu H, Mebazaa A. Amended STRONG-HF study design. Eur J Heart Fail. 2021 Nov;23(11):1981-1982. doi: 10.1002/ejhf.2348. Epub 2021 Oct 4. No abstract available.
Reference Type
DERIVED
Kimmoun A, Cotter G, Davison B, Takagi K, Addad F, Celutkiene J, Chioncel O, Solal AC, Diaz R, Damasceno A, Duengen HD, Filippatos G, Goncalvesova E, Merai I, Metra M, Ponikowski P, Privalov D, Sliwa K, Sani MU, Voors AA, Shogenov Z, Mebazaa A. 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. Eur J Heart Fail. 2019 Nov;21(11):1459-1467. doi: 10.1002/ejhf.1575. Epub 2019 Aug 19.
Reference Type
DERIVED
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
CHF201701
Identifier Type: -
Identifier Source: org_study_id
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