{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:32:41Z","timestamp":1787959961358,"version":"build-2784847793"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":746,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016545","name":"Roche Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016545","name":"Roche Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016545","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>Aim<\/jats:title>\n                    <jats:p>In this subgroup analysis of STRONG-HF, we explored the association between changes in renal function and efficacy of rapid up-titration of guideline-directed medical therapy (GDMT) according to a high-intensity care (HIC) strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In patients randomized to the HIC arm (n\u2009=\u2009542), renal function was assessed at baseline and during follow-up visits. We studied the association with clinical characteristics and outcomes of a decrease in estimated glomerular filtration rate (eGFR) at week 1, defined as \u226515% decrease from baseline. Patients in the usual care group (n\u2009=\u2009536) were seen at day 90. The treatment effect of HIC versus usual care was independent of baseline eGFR (p-interaction\u2009=\u20090.4809). A decrease in eGFR within 1\u2009week occurred in 77 (15.5%) patients and was associated with more rales on examination (p\u2009=\u20090.004), and a higher New York Heart Association class at the corresponding visit. Following the decrease in eGFR at 1\u2009week, lower average optimal doses of GDMT were prescribed during follow-up (p\u2009=\u20090.0210) and smaller reductions in N-terminal pro-B-type natriuretic peptide occurred (geometrical mean 0.81 in no eGFR decrease vs 1.12 in GFR decrease, p\u2009=\u20090.0003). The rate of heart failure (HF) readmission or death at 180\u2009days was 12.3% in no eGFR decrease versus 18.5% in eGFR decrease (p\u2009=\u20090.2274) and HF readmissions were 7.8% versus 16.6% (p\u2009=\u20090.0496).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the STRONG-HF study, HIC reduced 180-day HF readmission or death regardless of baseline eGFR. An early decrease in eGFR during rapid up-titration of GDMT was associated with more evidence of congestion, yet lower doses of GDMT during follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3074","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T04:14:12Z","timestamp":1698725652000},"page":"2230-2242","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Early Changes in Renal Function During Rapid Up-Titration of Guideline-Directed Medical Therapy Following an Admission for Acute Heart Failure"],"prefix":"10.1093","volume":"25","author":[{"given":"Jozine M.","family":"ter Maaten","sequence":"first","affiliation":[{"name":"University of Groningen, Department of Cardiology, University Medical Centre Groningen , Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Mebazaa","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM UMR-S 942 (MASCOT) , Paris ,","place":["France"]},{"name":"Department of Anesthesiology and Critical Care and Burn Unit, Saint-Louis and Lariboisi\u00e8re Hospitals, FHU PROMICE, DMU Parabol, APHP Nord , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Davison","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM UMR-S 942 (MASCOT) , Paris ,","place":["France"]},{"name":"Momentum Research Inc , Durham, NC ,","place":["USA"]},{"name":"Heart Initiative , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Edwards","sequence":"additional","affiliation":[{"name":"Momentum Research Inc , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Adamo","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Arrigo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Stadtspital Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianela","family":"Barros","sequence":"additional","affiliation":[{"name":"Momentum Research Inc , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Biegus","sequence":"additional","affiliation":[{"name":"Institute of Heart Diseases, Wroclaw Medical University , Wroc\u0142aw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"\u010celutkien\u0117","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":"Kamil\u0117","family":"\u010cerlinskait\u0117-Bajor\u0117","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","family":"Cohen-Solal","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM UMR-S 942 (MASCOT) , Paris ,","place":["France"]},{"name":"Department of Cardiology, APHP Nord, Lariboisi\u00e8re University Hospital , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albertino","family":"Damasceno","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Eduardo Mondlane University , Maputo ,","place":["Mozambique"]}],"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":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital , Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Gayat","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM UMR-S 942 (MASCOT) , Paris ,","place":["France"]},{"name":"Department of Anesthesiology and Critical Care and Burn Unit, Saint-Louis and Lariboisi\u00e8re Hospitals, FHU PROMICE, DMU Parabol, APHP Nord , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Kimmoun","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, Nancy\u2009; INSERM, D\u00e9faillance Circulatoire Aigue et Chronique\u2009; Service de M\u00e9decine Intensive et R\u00e9animation Brabois, CHRU de Nancy , Vand\u0153uvre-l\u00e8s-Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn S.P.","family":"Lam","sequence":"additional","affiliation":[{"name":"University of Groningen, Department of Cardiology, University Medical Centre Groningen , Groningen ,","place":["The Netherlands"]},{"name":"National Heart Centre Singapore and Duke-National University of Singapore \u00a0","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentine","family":"Leopold","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM UMR-S 942 (MASCOT) , Paris ,","place":["France"]},{"name":"Department of Anesthesiology and Critical Care and Burn Unit, Saint-Louis and Lariboisi\u00e8re Hospitals, FHU PROMICE, DMU Parabol, APHP Nord , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Novosadova","sequence":"additional","affiliation":[{"name":"Heart Initiative , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Pagnesi","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter S.","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Department of Medicine, Indiana University School of Medicine , Indianapolis, IN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Ponikowski","sequence":"additional","affiliation":[{"name":"Institute of Heart Diseases, Wroclaw Medical University , Wroc\u0142aw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadiza","family":"Saidu","sequence":"additional","affiliation":[{"name":"Murtala Muhammed Specialist Hospital \/ Bayero University Kano , Kano ,","place":["Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Sliwa","sequence":"additional","affiliation":[{"name":"Cape Heart Institute, Division of Cardiology, Department of Medicine, Groote Schuur Hospital and University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Takagi","sequence":"additional","affiliation":[{"name":"Momentum Research Inc , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Tomasoni","sequence":"additional","affiliation":[{"name":"Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences, 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