Medical Treatments in Patients With Ambulatory Heart Failure: First Data From the BRING-UP-3 Heart Failure Study.

Background: Current European Society of Cardiology guidelines introduced a 4-pillar approach for the treatment of HFrEF and a class IA recommendations for empagliflozin and dapagliflozin in HFmrEF and HFpEF.

Objectives: The BRING-UP-3 Heart Failure (HF) study was designed to guide the Guideline-implementation recommendations for patients with HF enrolled in a large sample of Italian cardiology sites.

Methods: The BRING-UP-3 HF study is an observational, prospective, nationwide investigation encompassing 179 sites and enrolling ambulatory and hospitalized patients with HF. The study includes an educational intervention followed by 2 3-month enrolment periods and by a 6-month follow-up period with end-point evaluation. For patients with HFrEF, the objective is to describe the proportion of patients who receive the 4 pillars. Here we present the baseline data of the ambulatory cohort.

Results: A total of 3830 ambulatory patients were included in the study. The mean age was 70 ± 12 years (34.5% older than 75 years), females were 21.9%. The most prevalent group was HFrEF (58.4%), followed by HFimpEF (17.4%), HFmrEF (14.4%), and HFpEF (9.8%). Hypertension, atrial fibrillation, diabetes mellitus, and chronic kidney disease were reported in 68.2%, 40.4%, 31.0%, and 33.1%, respectively. In patients with HFrEF, a high prescription rate (65%) for the 4 therapeutic pillars was observed; beta-blockers and RASis (mostly ARNIs) were prescribed in over 90%, while SGLT2is and MRAs were prescribed in over 80% of cases. In HFmrEF and HFpEF, SGLT2i prescription rates reached 72.1% and 50.1%, respectively.

Conclusions: A comprehensive analysis of a large sample of Italian cardiology sites revealed a high prevalence of prescription of guideline-recommended treatments.

Clinicaltrial: GOV: NCT06279988.