{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:32:10Z","timestamp":1790397130489,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"the Swiss National Science Foundation, the Swiss Heart Foundation","award":["FF22112"],"award-info":[{"award-number":["FF22112"]}]},{"DOI":"10.13039\/100008375","name":"the University of Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100016015","name":"the University Hospital Basel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016015","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the STANLEY THOMAS JOHNSON Foundation"},{"DOI":"10.13039\/100016015","name":"Universit\u00e4tsspital Basel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016015","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Sex-specific differences in acute heart failure (AHF) are both relevant and underappreciated. Therefore, it is crucial to evaluate the risk\/benefit ratio and the implementation of novel AHF therapies in women and men separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We performed a pre-defined sex-specific analysis in AHF patients randomized to a strategy of early intensive and sustained vasodilatation versus usual care in an international, multicentre, open-label, blinded endpoint trial. Inclusion criteria were AHF with increased plasma concentrations of natriuretic peptides, systolic blood pressure \u2265100\u2009mmHg, and plan for treatment in a general ward. Among 781 eligible patients, 288 (37%) were women. Women were older (median 83 vs. 76\u2009years), had a lower body weight (median 64.5 vs. 77.6\u2009kg) and lower estimated glomerular filtration rate (median 48 vs. 54\u2009ml\/min\/1.73\u2009m2). The primary endpoint, a composite of all-cause mortality or rehospitalization for AHF at 180\u2009days, showed a significant interaction of treatment strategy and sex (p for interaction\u2009=\u20090.03; hazard ratio adjusted for female sex 1.62, 95% confidence interval 1.05\u20132.50; p\u2009=\u20090.03). The combined endpoint occurred in 53 women (38%) in the intervention group and in 35 (24%) in the usual care group. The implementation of rapid up-titration of renin\u2013angiotensin\u2013aldosterone system (RAAS) inhibitors was less successful in women versus men in the overall cohort and in patients with heart failure with reduced ejection fraction (median discharge % target dose in patients randomized to intervention: 50% in women vs. 75% in men).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rapid up-titration of RAAS inhibitors was less successfully implemented in women possibly explaining their higher rate of all-cause mortality and rehospitalization for AHF.<\/jats:p>\n                    <jats:p>Clinical Trial Registration: ClinicalTrials.gov, unique identifier NCT00512759.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3065","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T21:28:41Z","timestamp":1698096521000},"page":"2218-2229","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comprehensive Vasodilatation in Women with Acute Heart Failure: Novel Insights from the GALACTIC Randomized Controlled Trial"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1793-5297","authenticated-orcid":false,"given":"Desiree","family":"Wussler","sequence":"first","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]},{"name":"Department of Internal Medicine, University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Belkin","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]},{"name":"Department of Internal Medicine, University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha T.","family":"Maeder","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kantonsspital St. Gallen , St. Gallen ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]},{"name":"Department of Medical Oncology and Hematology, University Hospital Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samyut","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Kupska","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Stierli","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dayana","family":"Flores","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Kozhuharov","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle Menosi","family":"Gualandro","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]},{"name":"Heart Institute (INCOR), University of Sao Paulo Medical School , Sao Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mucio Tavares","family":"de Oliveira Junior","sequence":"additional","affiliation":[{"name":"GREAT Research network , Rome ,","place":["Italy"]},{"name":"Heart Institute (INCOR), University of Sao Paulo Medical School , Sao Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid","family":"Sabti","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Noveanu","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thenral","family":"Socrates","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]},{"name":"Medical Outpatient Department, University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Bay\u00e9s-Genis","sequence":"additional","affiliation":[{"name":"Heart Institute, Hospital Universitari Germans Trias i Pujol, CIBERCV , Barcelona ,","place":["Spain"]},{"name":"Department of Medicine, Autonomous University of Barcelona , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Sionis","sequence":"additional","affiliation":[{"name":"Intensive Cardiac Care Unit, Cardiology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute IIB-Sant Pau, Universidad Aut\u00f3noma de Barcelona , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Simon","sequence":"additional","affiliation":[{"name":"Clinical Trial Unit, University Hospital of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Michou","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Gujer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Luzerner Kantonsspital , Luzern ,","place":["Switzerland"]},{"name":"Department of Internal Medicine, Kantonsspital Obwalden , Sarnen ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Gori","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center, Johannes Gutenberg University Mainz and German Center for Cardiovascular Research (DZHK) \u2013 Partner Site Rhine-Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Wenzel","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Medical Center, Johannes Gutenberg University Mainz and German Center for Cardiovascular Research (DZHK) \u2013 Partner Site Rhine-Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otmar","family":"Pfister","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Arenja","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Research network , Rome ,","place":["Italy"]},{"name":"Department of Cardiology, Solothurner Spit\u00e4ler AG, Kantonsspital Olten , Olten ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Kobza","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Luzerner Kantonsspital , Luzern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Rickli","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kantonsspital St. Gallen , St. Gallen 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