Observational studyESC heart failure2026
Medical treatments at 6 months in hospitalized and ambulatory HFrEF patients in the BRING-UP 3 Heart Failure study.
Observational study in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The trial behind it
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Who cites it
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Authors and funding
24 authors.
Funding
Abstract
introductionThe 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.
methodsBRING-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.
resultsAmong 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.
conclusionIn 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.
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