{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:34:00Z","timestamp":1790678040013,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T00:00:00Z","timestamp":1566172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T00:00:00Z","timestamp":1566172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Patients admitted for acute heart failure (HF) are at high risk of readmission and death, especially in the 90\u2009days following discharge. We aimed to assess the safety and efficacy of early optimization of oral HF therapy with beta-blockers (BB), angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) or angiotensin receptor\u2013neprilysin inhibitors (ARNi), and mineralocorticoid receptor antagonists (MRA) on 90-day clinical outcomes in patients admitted for acute HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a multicentre, randomized, open-label, parallel-group study, a total of 900 patients will be randomized in a 1:1 ratio to either \u2018usual care\u2019 or \u2018high-intensity care\u2019. Patients enrolled in the usual care arm will be discharged and managed according to usual clinical practice at the site. In the high-intensity care arm, doses of oral HF medications \u2013 including a BB, ACEi or ARB, and MRA \u2013 will be up-titrated to 50% of recommended doses before discharge and to 100% of recommended doses within 2 weeks of discharge. Up-titration will be delayed if the patients develop worsening<\/jats:p>\n                    <jats:p>symptoms and signs of congestion, hyperkalaemia, hypotension, bradycardia, worsening of renal function or significant increase in N-terminal pro-B-type natriuretic peptide between visits. The primary endpoint is 90-day all-cause mortality or HF readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>STRONG-HF is the first study to assess whether rapid up-titration of evidence-based guideline-recommended therapies with close follow-up in a large cohort of patients discharged from an acute HF admission is safe and can affect adverse outcomes during the first 90\u2009days after discharge.<\/jats:p>\n                    <jats:p>Clinical Trial Registration: ClinicalTrials.gov Identifier NCT03412201.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.1575","type":"journal-article","created":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T04:16:35Z","timestamp":1566188195000},"page":"1459-1467","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["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"],"prefix":"10.1093","volume":"21","author":[{"given":"Antoine","family":"Kimmoun","sequence":"first","affiliation":[{"name":"INSERM UMR-S 942, St. Louis and Laribois\u00e8re University Hospitals, Paris University , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gad","family":"Cotter","sequence":"additional","affiliation":[{"name":"Momentum Research Inc. , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Davison","sequence":"additional","affiliation":[{"name":"Momentum Research Inc. , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Takagi","sequence":"additional","affiliation":[{"name":"INSERM UMR-S 942, St. Louis and Laribois\u00e8re University Hospitals, Paris University , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faouzi","family":"Addad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Abderrahmen Mami University hospital , Ariana ,","place":["Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Celutkiene","sequence":"additional","affiliation":[{"name":"Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University , Vilnius ,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu","family":"Chioncel","sequence":"additional","affiliation":[{"name":"Emergency Institute for Cardiovascular Diseases \u2018Prof. C.C. Iliescu\u2019, University of Medicine \u2018Carol Davila\u2019 , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain Cohen","family":"Solal","sequence":"additional","affiliation":[{"name":"INSERM UMR-S 942, St. Louis and Laribois\u00e8re University Hospitals, Paris University , Paris ,","place":["France"]},{"name":"Department of Cardiology, Laribois\u00e8re University Hospital , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Diaz","sequence":"additional","affiliation":[{"name":"Estudios Cl\u00ednicos Latinoam\u00e9rica, Instituto Cardiovascular de Rosario , Rosario ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albertino","family":"Damasceno","sequence":"additional","affiliation":[{"name":"Eduardo Mondlane University Hospital , Maputo ,","place":["Mozambique"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Dirk","family":"Duengen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine - Cardiology, Campus Virchow Klinikum, Charit\u00e9 - Universit\u00e4tsmedizin Berlin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Attikon University Hospital, National and Kapodistrian University of Athens, Greece; 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