Evidence map›Paper›PMID 39938529›Full record

Trial reportESC heart failure2025

Socio-economic status and the effect of guideline-directed medical therapy in the STRONG-HF study.

Albertino Damasceno, Hadiza Saidu, Gad Cotter, Beth Davison, Christopher Edwards, Jelena Celutkiene, Marianna Adamo, Mattia Arrigo, Marianela Barros, Jan Biegus and 20 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Albertino DamascenoFaculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
Hadiza SaiduDepartment of Medicine, Murtala Muhammed Specialist Hospital/Bayero University Kano, Kano, Nigeria.
Gad CotterUniversité Paris Cité, INSERM UMR-S 942 (MASCOT), Paris, France.
Beth DavisonUniversité Paris Cité, INSERM UMR-S 942 (MASCOT), Paris, France.
Christopher EdwardsMomentum Research Inc, Durham, NC, USA.
Jelena CelutkieneClinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Marianna AdamoCardiology, Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Mattia ArrigoDepartment of Internal Medicine, Stadtspital Zurich, Zurich, Switzerland.
Marianela BarrosMomentum Research Inc, Durham, NC, USA.
Jan BiegusInstitute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland.
Kamilė Čerlinskaitė-BajorėClinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Ovidiu ChioncelEmergency Institute for Cardiovascular Diseases "Prof. C.C. Iliescu", University of Medicine "Carol Davila", Bucharest, Romania.
Alain Cohen-SolalUniversité Paris Cité, INSERM UMR-S 942 (MASCOT), Paris, France.
Benjamin DeniauUniversité Paris Cité, INSERM UMR-S 942 (MASCOT), Paris, France.
Rafael DiazEstudios Clínicos Latinoamérica, Instituto Cardiovascular de Rosario, Rosario, Argentina.
Gerasimos FilippatosNational and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece.
Etienne GayatUniversité Paris Cité, INSERM UMR-S 942 (MASCOT), Paris, France.
Antoine KimmounUniversité de Lorraine, Nancy; INSERM, Défaillance Circulatoire Aigue et Chronique; Service de Médecine Intensive et Réanimation Brabois, CHRU de Nancy, 54511, Vandœuvre-lès-Nancy, France.
Carolyn S P LamNational Heart Centre Singapore and Duke-National University of Singapore, Singapore, Singapore.
Marco MetraCardiology, Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Maria NovosadovaMomentum Research Inc, Durham, NC, USA.
Matteo PagnesiCardiology, Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Peter S PangDepartment of Emergency Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Piotr PonikowskiInstitute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland.
Jozine M Ter MaatenUniversity of Groningen, Department of Cardiology, University Medical Centre Groningen, Groningen, Netherlands.
Daniela TomasoniCardiology, Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Adriaan A VoorsUniversity of Groningen, Department of Cardiology, University Medical Centre Groningen, Groningen, Netherlands.
Koji TakagiMomentum Research Inc, Durham, NC, USA.ORCID https://orcid.org/0000-0003-0213-1509
Alexandre MebazaaUniversité Paris Cité, INSERM UMR-S 942 (MASCOT), Paris, France.
Karen SliwaCape Heart Institute, Division of Cardiology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.

Funding

Roche Diagnostics
6 · The paper itself

Abstract

aimsAcute heart failure (AHF) impacts millions globally, with outcomes varying based on socio-economic status (SES).

methodsSES measured by annual household income, years of education and medical insurance coverage. Each patient's income and education level relative to the median or mean, respectively, in the country was calculated, and categorized into tertiles (0, 1 or 2 from lowest to highest). SES scores (0-5) were computed as the sum of these levels plus insurance coverage (0 = no or 1 = yes). Patients' baseline characteristics, outcomes (HF readmission, death and their composite) and the effect of high-intensity care (HIC) vs. usual care (UC) were examined by SES scores 0-2, 3 and 4-5.

resultsLower SES patients, who were younger, predominantly female, Black and non-European, had fewer comorbidities such as atrial fibrillation, diabetes and ischaemic heart disease and exhibited milder HF, indicated by a lower NYHA class, lower creatinine and higher cholesterol before discharge. Despite having milder HF and less comorbidities, after adjusting for baseline characteristics, patients with higher SES had numerically better outcomes, though differences were not statistically significant. 180-day hazard ratios (HRs) for HF readmission or death were 0.75 (95% CI 0.48-1.16) for SES scores of 3 and 0.85 (95% CI 0.58-1.23) for scores of 4-5, compared to 0-2. Higher SES patients had numerically better treatment effect from HIC, with HRs of 0.69 for SES 0-2, 0.72 for SES 3 and 0.50 for SES 4-5.

conclusionsIn this post hoc analysis of the STRONG-HF study, lower SES was associated with milder acute HF but similar 180-day outcomes. Higher SES patients benefitted more from HIC.

Indexed as

Heart FailurePractice Guidelines as TopicSocial ClassAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedAcute heart failureGuideline‐directed medical therapySocio‐economic status

Identifiers

PMID39938529
PMCPMC12055368

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.