STRONG-HF results demonstrate clear benefits for acute heart failure patients by adapting care strategy

On  November 7th 2022, the results of the STRONG-HF trial were published in The Lancet1


The major outcomes of this groundbreaking study, can have huge a implications on acute heart failure (HF) patient management in the near future benefiting heart failure patients globally. 


The current situation

Worldwide more than 64 million people suffer from heart failure2. This has a huge impact on the healthcare system, but more importantly on patients and their families. Post-discharge acute heart failure patient management has been challenging. One of the reasons for this is the fact that fast implementation of many oral therapies has not been supported by robust evidence1


STRONG-HF was designed to test whether rapid up-titration of treatments - after an admission for acute heart failure - was safe and could alter the prognosis of patients in the vulnerable early post-discharge period3. The active arm of the study comprised a rapid up-titration of therapies and a close follow-up period with frequent NT-proBNP levels measurements . Because of the superior efficacy of the active arm of the study versus the usual standard of care, STRONG-HF was terminated early, as it was considered unethical to continue with usual care.

The results

Overall, an intensive treatment strategy was readily accepted by patients as it reduced symptoms, improved quality of life, and reduced the risk of 180-day all-cause death or heart failure readmission compared with usual care1. More specifically, the primary outcomes of STRONG-HF showed a 34% relative and 8.1% absolute death or HF readmission risk reduction. 


Roche Elecsys® NT-proBNP biomarker


Tests for NT-proBNP, a cardiac hormone that is released into the blood when the heart wall is stretched, are developed by Roche. The Roche Elecsys NT-proBNP is an objective biomarker for the aid in diagnosis in individuals suspected of having congestive heart failure. The test is further indicated for the risk stratification of patients with acute coronary syndrome and congestive heart failure and as an aid in assessment of increased risk of cardiovascular events and mortality in patients at risk for heart failure who have stable coronary artery disease.4 The Elecsys electrochemiluminescence immunoassay “ECLIA'' is intended for use on cobas e immunoassay analyzers. 

The Elecsys® NT-proBNP biomarker was an integral part of the treatment strategy, comprising rapid up-titration and close follow up after an acute heart failure admission. 


1. Mebazaa A, 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. 2022;S0140-6736(22)02076-1.

2. Bragazzi NL, et al. Burden of heart failure and underlying causes in 195 countries and territories from 1990 to 2017.  Eur. J. Prev. Cardiol. 2021; 28(15):1682-1690.

3., NCT03412201 [Internet; cited 2022 Dec 1]. Available from:

4. NT-proBNP method sheet.


STRONG-HF is an investigator-initiated study, funded through a grant provided to the Heart Initiative by Roche Diagnostics International.