ESC heart failure · 2026
Medical treatments at 6 months in hospitalized and ambulatory HFrEF patients in the BRING-UP 3 Heart Failure study.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Oliva Fabrizio, Orso Francesco, Colivicchi Furio, Cipriani Manlio Gianni, Di Lenarda Andrea, Gori Mauro, Gorini Marco, Iacoviello Massimo, Lucci Donata, Marini Marco, Bonvicini Eleonora, Carugo Stefano, Catalano Mariarosaria, D'Elia Emilia, Gentile Piero, Matassini Maria Vittoria, Navazio Alessandro, Russo Domitilla, Tini Giacomo, Tinti Maria Denitza, Grimaldi Massimo, Gabrielli Domenico, Maggioni Aldo Pietro, BRING-UP 3 Heart Failure Investigators
Аннотация
INTRODUCTION: The BRING-UP 3 Heart Failure (HF) study was designed to evaluate the real-world implementation of guideline-directed medical therapy (GDMT) for patients with heart failure with reduced ejection fraction (HFrEF), given the limited evidence on the uptake of the contemporary four-pillar treatment strategy.
METHODS: BRING-UP 3 HF study is an observational, prospective, nationwide investigation encompassing 179 sites. This analysis includes HFrEF patients enrolled in the ambulatory and hospitalized cohorts with complete pharmacological data at 6-month follow-up. The objective was to describe the use of the four GDMT pillars after 6 months.
RESULTS: Among 3201 HFrEF patients enrolled, 142 (4.4%) had died by 6 months, and treatment data were available for 2950 patients. Mean age was 69 ± 11 years (26.6% > 75 years), 18.0% were female. Prescription rates of GDMT were high at baseline and remained stable over 6-months, with a shift from ACE-I/ARBs to ARNIs, and a modest increase in SGLT2i use. A significant reduction in diuretic prescription was also observed. Quadruple therapy was prescribed in 64.3% of patients at 6 months versus 63.9% at baseline/discharge (P = NS), while quadruple therapy including ARNI went from 52.9% to 55.9%, P < .0001. Dose up-titration of GDMT remained suboptimal, with most agents prescribed at <50% of target doses. Discontinuation rates at follow-up were very low.
CONCLUSION: In this large nationwide cohort, guideline-directed therapies for HFrEF were widely implemented and maintained over 6 months with excellent treatment persistence. However, dose optimization remains a key unmet need in routine clinical practice.
METHODS: BRING-UP 3 HF study is an observational, prospective, nationwide investigation encompassing 179 sites. This analysis includes HFrEF patients enrolled in the ambulatory and hospitalized cohorts with complete pharmacological data at 6-month follow-up. The objective was to describe the use of the four GDMT pillars after 6 months.
RESULTS: Among 3201 HFrEF patients enrolled, 142 (4.4%) had died by 6 months, and treatment data were available for 2950 patients. Mean age was 69 ± 11 years (26.6% > 75 years), 18.0% were female. Prescription rates of GDMT were high at baseline and remained stable over 6-months, with a shift from ACE-I/ARBs to ARNIs, and a modest increase in SGLT2i use. A significant reduction in diuretic prescription was also observed. Quadruple therapy was prescribed in 64.3% of patients at 6 months versus 63.9% at baseline/discharge (P = NS), while quadruple therapy including ARNI went from 52.9% to 55.9%, P < .0001. Dose up-titration of GDMT remained suboptimal, with most agents prescribed at <50% of target doses. Discontinuation rates at follow-up were very low.
CONCLUSION: In this large nationwide cohort, guideline-directed therapies for HFrEF were widely implemented and maintained over 6 months with excellent treatment persistence. However, dose optimization remains a key unmet need in routine clinical practice.