{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:52:54Z","timestamp":1792644774012,"version":"4.5.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>This analysis provides details on baseline and changes in quality of life (QoL) and its components as measured by EQ-5D-5L questionnaire, as well as association with objective outcomes, applying high-intensity heart failure (HF) care in patients with acute HF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>In STRONG-HF trial (Safety, Tolerability, and Efficacy of Rapid Optimization, Helped by NT-proBNP Testing, of Heart Failure Therapies) patients with acute HF were randomized just before discharge to either usual care or a high-intensity care strategy of guideline-directed medical therapy up-titration. Patients ranked their state of health on the EQ-5D visual analog scale score ranging from 0 (the worst imaginable health) to 100 (the best imaginable health) at baseline and at 90 days follow-up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              In 1072 patients with acute HF with available assessment of QoL (539\/533 patients assigned high-intensity care\/usual care) the mean baseline EQ-visual analog scale score was 59.2 (SD, 15.1) with no difference between the treatment groups. Patients with lower baseline EQ-visual analog scale (meaning worse QoL) were more likely to be women, self-reported Black and non-European (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001). The strongest independent predictors of a greater improvement in QoL were younger age (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001), no HF hospitalization in the previous year (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001), lower NYHA class before hospital admission (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) and high-intensity care treatment (mean difference, 4.2 [95% CI, 2.5\u20135.8];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001). No statistically significant heterogeneity in the benefits of high-intensity care was seen across patient subgroups of different ages, with left ventricular ejection fraction above or below 40%, NT-proBNP (N-terminal pro-B-type natriuretic peptide) and systolic blood pressure above or below the median value. The treatment effect on the primary end point did not vary significantly across baseline EQ-visual analog scale (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              =0.87).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Early up-titration of guideline-directed medical therapy significantly improves all dimensions of QoL in patients with HF and improves prognosis regardless of baseline self-assessed health status. The likelihood of achieving optimal doses of HF medications does not depend on baseline QoL.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03412201.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.123.011221","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T14:05:38Z","timestamp":1709733938000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Impact of Rapid Up-Titration of Guideline-Directed Medical Therapies on Quality of Life: Insights From the STRONG-HF Trial"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct03412201","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3562-9274","authenticated-orcid":true,"given":"Jelena","family":"\u010celutkien\u0117","sequence":"first","affiliation":[{"name":"Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Lithuania (J.\u010c., K.\u010c-B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6753-9356","authenticated-orcid":true,"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, Lithuania (J.\u010c., K.\u010c-B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gad","family":"Cotter","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, INSERM UMR-S 942 (MASCOT), France (G.C., A.C.-S., E.G., V.L., A.M., B.D.)."},{"name":"Heart Initiative, Durham, NC (G.C., B.D.)."},{"name":"Momentum Research, Inc, Durham, NC. (G.C., C.E., M.B., M.N., K.T., B.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4908-9758","authenticated-orcid":true,"given":"Christopher","family":"Edwards","sequence":"additional","affiliation":[{"name":"Momentum Research, Inc, Durham, NC. (G.C., C.E., M.B., M.N., K.T., B.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3855-1815","authenticated-orcid":true,"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, Italy (M. Adamo, M.M., M.P., D.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4028-2869","authenticated-orcid":true,"given":"Mattia","family":"Arrigo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Stadtspital Zurich, Switzerland (M. Arrigo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianela","family":"Barros","sequence":"additional","affiliation":[{"name":"Momentum Research, Inc, Durham, NC. 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