December 2023 at a glance: Focus on medical therapy in chronic and acute heart failure

Abstract

Acute HF is still associated with poor prognosis and efforts are needed to improve its prognosis. 21,22 A pre-defined sex-specific analysis of the GALACTIC (Goal directed afterload reduction acute congestive cardiac decompensation study) trial showed that a strategy of early intensive and sustained vasodilatation with rapid up-titration of renin-angiotensin-aldosterone system (RAAS) inhibitors versus usual care was less successful in women versus men both in the overall cohort and in patients with HFrEF. 23 In a previous analysis no significant treatment-by-sex interactions were found in the STRONG-HF trial. 24 Implementation of GDMT affects kidney function. 8 An analysis of STRONG-HF described the association between changes in renal function and efficacy of rapid up-titration of GDMT according to the high-intensity care (HIC) strategy. The HIC group had less HF readmissions or death regardless of baseline eGFR at 180 days. An early decrease in eGFR at 1 week was associated with