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. 2025 Mar 20:S1071-9164(25)00144-7.
doi: 10.1016/j.cardfail.2025.02.019. Online ahead of print.

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

Fabrizio Oliva  1 , Francesco Orso  2 , Furio Colivicchi  3 , Manlio Gianni Cipriani  4 , Andrea Dilenarda  5 , Domenico Gabrielli  6 , Mauro Gori  7 , Marco Gorini  2 , Massimo Iacoviello  8 , Donata Lucci  2 , Marco Marini  9 , Francesco Amico  10 , Daniele Bertoli  11 , Samuela Carigi  12 , Emilia D'Elia  7 , Stefania Angela Difusco  3 , Alessandro Fucili  13 , Gianluca Lanati  14 , Alessandra Menegato  15 , Michele Moretti  16 , Alessandro Navazio  17 , Andrea Passantino  18 , Giovanni Pulignano  19 , Matteo Ruzzolini  20 , Angela Beatrice Scardovi  21 , Alberto Somaschini  22 , Aldo Pietro Maggioni  23 ; on the behalf of BRING-UP-3 Heart Failure Investigators
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Free article

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

Fabrizio Oliva et al. J Card Fail. .
Free article

Abstract

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.

Keywords: Chronic heart failure; adherence; guidelines; medical treatments; registry.

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Conflict of interest statement

Disclosures F. Oliva. has received personal fees from AstraZeneca, Novartis, Boehringer, Bayer, Menarini, Amgen, Sanofi, and Novonordisk and participates in committees of studies sponsored by Novartis, Boehringer, Bayer, Sanofi, Amgen, AstraZeneca, and Novonordisk not related to the current study. D.G. is the president of Heart Care Foundation, and he participated in the committee of Pure Study DSMB. M. Gorini, D.L. and F. Orso. are employees of Heart Care Foundation, Florence, Italy. S.C. received support to attend the Investigator Meeting of this research project. M.G. received personal fees from Boehringer, AstraZeneca, Novartis, Menarini, Amgen, and Bayer and personal fees for participation in committees of studies sponsored by Amgen and Boehringer not related to the current study. M.I. has received personal fees from AstraZeneca, Boehringer Ingelheim, Novartis, Neopharmed Gentili, Bayer; support for attending meetings from AstraZeneca and has received personal fees for participation in committees of studies sponsored by Eli Lilly, Boehringer Ingelheim, Novartis, and Bayer not related to the current study. M.M. has received honoraria for lectures and presentations from Astra Zeneca and Boehringer Ingelheim not related to the current study. A. F. has received personal fees from AstraZeneca, Bayer, Boehringer, Neopharmed Gentili, Novartis, Servier, and Vifor Pharma not related to the current study. M.M. has received honoraria for presentations and educational events from AstraZeneca, Boeringer Ingelheim, Novartis, and Sanofi and support for attending meetings from Alnylam Pharmaceuticals, not related to the current study. G.P. has received personal fees from Boehringer, AstraZeneca, Novartis, and Bayer, not related to the current study. A.B.S. has received direct payment for educational events by AstraZeneca, Boehringer Ingelheim, and Novartis not related to the current study. A.P.M. has received personal fees for participation in committees of studies sponsored by AstraZeneca, Bayer, Novartis, and Sanofi not related to the current study. All other authors have no conflicts of interest to disclose

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