An Australian perspective on the STRONG-HF study


Prof. Andrew JS Coats, Scientific Director and CEO, Heart Research Institute, Sydney

In June, 2023 Roche Diagnostics Australia was delighted to speak with Professor Andrew JS Coats, Scientific Director and CEO, Heart Research Institute, Sydney.

In the first of the below videos, Prof. Coats gives an overview of heart disease in an Australian context. In the second video, Prof. Coats shares more specific insight into the STRONG-HF study. He discusses how the findings can be used to improve acute heart failure treatment in Australia, and the integral role played by NT-proBNP, in safety and for informing dose adjustments and monitoring prognosis.

Heart failure in Australia

Heart failure (HF) is a major cause of disability globally, with a prevalence of approximately 1–2% of the adult population in developed countries [1]. HF prevalence is increasing due to an aging population, as noted by Prof. Coats, as well as prolonged survival of HF patients due to the availability of effective diagnostic and therapeutic interventions, [1]. However, HF prognosis remains poor, with a 5-year survival rate of approximately 50% [2].

From Research to Clinical Practice: Implementation of STRONG-HF in Heart Failure Management

Prof. Coats says "The STRONG-HF study demonstrates that rapid up-titration of GDMT and rigorous monitoring mediated by NT-proBNP improves patient outcomes [4]."

“Trials like STRONG-HF show that we need a sense of urgency..... Most modern guidelines are now recommending rapid achievement of adequate GDMT doses. To encourage the implementation of these recommendations into routine practice, clinical education and reimbursement are key."

“Doctors and nurses in primary care need to be actively involved [in HF]. They need to be supported and feel like they are part of a multidisciplinary team,” Prof. Coats noted.

“Specialist expertise, which is much more limited, has to be made available and readily accessible for primary care, who will carry the major burden of managing HF”.

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Reference 1 - A. J. S. Coats, "Ageing, demographics, and heart failure," European Heart Journal Supplements, vol. 21, no. Supplement_L, pp. L4-L7, 2019, doi: 10.1093/eurheartj/suz235.

Reference 2 - Lopez - Sendon J. The Heart Failure Epidemic. Medicographia 2011; 33: 363-369

Reference 3 -  J. Howlett, J. Comin-Colet, K. Dickstein, A. Fuat, G. Pölzl, and S. Delaney, "Clinical practices and attitudes regarding the diagnosis and management of heart failure: findings from the CORE Needs Assessment Survey," (in eng), ESC Heart Fail, vol. 5, no. 1, pp. 172-183, Feb 2018, doi: 10.1002/ehf2.12205.

Reference 4 - A. Mebazaa et al., "Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial," The Lancet, vol. 400, no. 10367, pp. 1938-1952, 2022/12/03/ 2022, doi: