Britons with heart failure are being given larger doses of drugs at the start of their treatment after a global trial found this drastically cut deaths.
St George’s Hospital in Tooting, London, and Morriston Hospital in Swansea, Wales, became the first two hospitals in the UK to treat patients with the innovative method, which those involved describing it as a “total game-changer” for the condition.
The hospitals were part of a multinational clinical trial, involving 87 hospitals in 14 countries, of an “aggressive” treatment for the potentially fatal condition.
Evidence from the study already suggests that the treatment has cut deaths by nearly two-thirds and lowered their risk of returning to hospital by 30 per cent.
Heart failure affects one million people in the UK. The incurable condition means the heart can no longer pump blood around the body as effectively, leaving sufferers tired and breathless.
Matthew Sunter, Lead Heart Failure Nurse at St George’s, said: “Heart failure kills as many people as cancer, yet cancer treatments such as chemotherapy start faster. Now, armed with our new knowledge, we’re able to replicate this with heart failure patients, starting them on higher doses of medicines and increasing them much more quickly – in around three weeks, as opposed to several months.
“I’ve been in this role 10 years, and when I started I never imagined we could treat patients in this manner. We’ve come a really long way, and I’m so proud of the work we’ve been doing at St George’s.”
Eligible patients at St George’s – home to the UK’s only dedicated specialist heart failure unit – will now receive “optimal” doses of heart-failure medicines – made possible by frequent monitoring and testing, following strong evidence from the clinical trial.
It means some patients will ramp up treatment much more quickly, as an optimal dose of medicine is the amount that gives the best balance between effectiveness and safety – or taking enough of the medicine to treat the condition without causing harmful side effects.
Morriston Hospital-based Dr Parin Shah, a cardiology consultant specialising in heart failure, called the medicines “quite powerful.”
“They help the heart tremendously, but they affect the patient’s blood pressure and their kidney function, which could cause problems in optimising the treatment,” Dr Shah said.
“Hence the guidance, until recently, was to take a slow approach to optimising the treatment for heart failure which could take six months or longer.
The STRONG-HF trial enrolled over 1,000 patients and compared a new protocol, which saw patients receive earlier and quicker up-titration of heart failure therapies alongside more frequent testing and monitoring, with more traditional protocols, which saw patients placed on smaller amounts of drugs, increased over several months.
Dr Shah continued: “STRONG-HF has shown that it is not only safe to optimise medications within six to 10 weeks but provides rapid symptom benefit to patients.”
While not everyone will be eligible for this treatment, as some people may not be able to tolerate the “intensive” approach, Dr Shah said “we knew it would be suitable for relatively few people, but it would benefit them considerably.”
