Vietnamese Rapid Acceleration Protocol for Starting and Quickly Increasing Heart Failure Medicines in Hospitalized Adults with Reduced Ejection Fraction

What this Trial Is About

Researchers are evaluating a treatment approach for hospitalized Asian patients with acute heart failure and reduced ejection fraction. This open-label, multicenter randomized trial compares a rapid, standardized initiation and adjustment of four key heart failure medications against usual care. The goal is to assess whether this approach can improve safety and reduce death or rehospitalization within 180 days after discharge. The study involves two groups one receives usual care managed by their cardiologist, and the other follows a high-intensity care protocol. In the high-intensity group, patients start all four heart failure medications RAS inhibitors, beta-blockers, MRAs, and SGLT2 inhibitors before hospital discharge at a quarter of the target dose. They then undergo a structured six-week outpatient program with four follow-up visits to increase medication doses up to 75% of typical targets, considering lower blood pressure common in Asian populations. Participants will be closely monitored through physical exams, lab tests including NT-proBNP, kidney function, and electrolytes during and after the treatment period. Clinical outcomes like mortality and heart failure rehospitalization will be assessed at 90 and 180 days post-discharge. The study includes a total follow-up period of 180 days to evaluate the effectiveness and safety of this intensified treatment strategy.

Vietnamese Rapid Acceleration Protocol for Intensifying Drug Therapy in Heart Failure With Reduced Ejection Fraction